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The Secrets Doctors Don't Tell You About Prescription Medicine

...that can save you money!

by Stella Fitzgibbons, M.D., F.A.C.P.

Prescription Medicine

You just filled that new prescription… and now you wonder if you should call the doctor again to ask for a sedative. Your high blood pressure (or sinus infection or arthritis) suddenly became a major budget item. What can you do to change that?

The doctor’s office is unfamiliar territory. You know Doc has lots of other patients to see; you don’t want to be a bother. But it’s critically important to let health-care providers know when something threatens your ability to follow a treatment plan, and the cost of medicine today can do that as effectively as a hurricane or snowstorm.

A look at how doctors decide what prescription to write shows there are some well-kept secrets that can help you save at the pharmacy without cutting corners on your medical care.

Prescription Medicine

Your doctor almost always has more than one TREATMENT OPTION.

High-blood-pressure medicines, for example, come in several different classes. And the pills in each class can cost anywhere from a few dollars a month to the-sky’s-the-limit. Sometimes one of the expensive classes is necessary—for example, if you have heart failure or kidney problems—but most people can get by just fine with an older (and cheaper) type of pill.


The doctor mentally kicked around several choices before writing that prescription, and may have no idea it’s the most expensive drug in its class. It’s worth asking whether it’s the only one that will work.

Prescription Medicine

The larger the number of people who have a problem, the more options the pharmaceutical industry will have to offer.

Precription MedicineJoint and muscle pain generates billions of dollars of drug sales every year, from amateur athletes and home repairmen with minor sprains, to the thousands of people with disabling arthritis. As a result, there are dozens of anti-inflammatory drugs for that pain. If one manages to cover only 1 percent of that market, the company making it can declare a nice profit.

If you have something you know you share with a lot of other people, you shouldn’t have to shell out money your insurance won’t cover for the latest “me-too” drug in a class. Ask the doctor what else you can take.

Prescription Medicine

“Free” samples aren’t really.

No pharmaceutical company gives out samples of a medicine, however effective, that has been on the market for years. Your doctor’s sample cabinet contains only the latest products. Most are expensive variations on older meds that offer little real advantage (except to the manufacturer’s cash flow), and brand-new classes of meds that have been tested by fewer patients than their competitors.

Precription Medicine

Oh, once in a while the doc can scrape together enough samples of a new antibiotic to treat a short-term infection. But for maintenance meds you’ll need indefinitely, samples are just a way to convince you that HyperHot or PainSchmain is the solution to a problem that will be with you long after that sample pack is gone. And in a month or two, when Doc asks the drug rep for more, the reply is that, gosh darn it, they’re not sampling that one any more.

Prescription Medicine

Large drugstore chains - and their list of low-cost meds - are your friends.

Not only do the chains buy in quantities large enough to get price breaks, but their Web sites will give you a list of medications in each class that they’ll provide for a small monthly fee. These are listed by category and diagnosis.

If you or a family member is paying big bucks for several meds, check them out. If one ulcer medicine isn’t on their list, another maybe, and Doc would probably rather try you on a second-choice drug than get called to the hospital when your ulcer develops complications.

Prescription Medicine

A small advantage may not be worth the difference in cost.

You may decide that avoiding the dry mouth that bladder-control pill gives you is not worth the additional $60 a month its newest competitor will cost. Choosing an antibiotic that’s only 92-percent effective instead of one with a 96-percent rating may be a risk, but for 50 bucks you may be willing to take it (and call the doctor promptly if it doesn’t seem to be working). Many minor infections will even resolve on their own, if more slowly, if you don’t take any antibiotic.

Prescription Medicine

You can get the information you need to ask questions.

Read whatever pamphlets or handouts your doctor gives you to explain your problems. Check trusted Web sites. not only gives extensive descriptions of why and when to use that medication, but its cost-saving option lists potentially less expensive alternatives.

A recent study in Archives of General Medicine found that many diabetic patients receive newer, more expensive drugs even when older ones would be just as effective. Insurance that has prescription coverage can encourage health-care providers to forget the price difference between meds, but if you’re paying full price it makes a huge financial difference.

Ask questions. Stay informed, and get your information from reliable sources. This is good advice for protecting your health and it will help your bank balance, as well.


Stella Fitzgibbons, M.D., F.A.C.P., is a hospitalist with IPC The Hospitalist Company in Houston. She also wrote this issue’s article on how the adrenal glands work, page 29.

Comments (1)add comment
Wait! Don't forget the pharmacist!
written by David , January 04, 2013

Dr. Fitzgibbons has given us some very wise and valuable advice, for which I thank her. Discussing money - saving alternatives with the doctor before she writes that prescription is certainly the best way to reduce the cost of treatment. However, the pharmacist who fills that prescription is also able to help. While a pharmacist cannot change what is prescribed, he or she can recognize when a less expensive drug might be effective, call the doctor, and discuss the possibility of changing what is prescribed. Of course, doctors and pharmacists are very busy, which is why it is best to discuss alternatives with the prescribing doctor first; but do not hesitate to consult your pharmacist, too. You will be surprised how much they know, and how often they can be your advocate for less expensive choices.

Oh, and, not that it matters, but since some who read this will want to know, NO, I am not a pharmacist nor do I work for a pharmacy or drug company. I am an RN and I do not make or loose a nickel on the basis of which medication you end up with. Doesn't affect my wallet one bit. I just like my patients to know all of the resources available to them, and to enjoy the most benefit from their health care providers.

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