There's help to rein in drug costs

Generics and mail order among the best ways to save

These days the price of prescription drugs can seem harder to swallow than the pills themselves. Operators of health-related hot lines say they've been swamped with calls from consumers looking for cheaper alternatives. For young families and seniors - two groups that tend to use more medications - the costs can be eye-popping. While there may not be a ready cure for the nation's soaring healthcare costs, there are a number of cost-cutting tips to ease the pain. Here are some favorites from pharmacists who help callers at MassMedLine, 866-633-1617 or www.massmedline.com, a free information service run by the Massachusetts College of Pharmacy and Health Sciences.

Think generic. When your doctor is prescribing a medication, make sure you ask for a generic form of the medicine instead of the name brand.

State law requires that if a generic version is available, pharmacists must dispense it, unless a physician indicates otherwise. In most cases, the generic is appropriate and certainly cheaper, but MassMedLine counselors urge caution on this. For instance, some patients may be taking two or three different heart medications and each one may work slightly differently than its generic counterpart. Before going the cheapest route, the counselors say patients should discuss the substitutions with their doctors to make sure there are no potentially harmful drug conflicts.

Check chain stores' prescription programs. A number of stores, including Wal-Mart, Target, CVS, and Walgreens, are offering bargains for generic drugs that are cheaper than the copay typically charged by prescription coverage through health insurance. Wal-Mart and Target are offering a month's supply of generic drugs for $4 and a 90-day supply for $10. CVS and Walgreens have similar programs, but charge annual fees. These programs generally offer generic drugs only, and not all generics are included, so if you are taking a combination of generic and name brand medicines, you may end up having to make an extra trip if you choose a program that is not in a store where you typically fill other prescriptions.

MassMedLine counselors suggest that patients who are shopping around keep a list handy of all the drugs they and their family members are taking - the nonprofit offers free wallet cards for this purpose.

"We encourage people to carry around their medication history because they are fragmenting their healthcare now," said Mary Sullivan, a pharmacist who directs MassMedLine. "The pharmacists at these sites may not know their history, and carrying it may prevent any untoward (drug) reactions."

Consider mail order. Many health insurance companies offer mail order options for their prescription coverage programs. The option includes name brand drugs and tends to be cheaper than filling these prescriptions monthly at the local pharmacy. It can also be more convenient and a time-saver. The programs typically offer a three-month supply for the price of a two-month copay. Some give a three-month supply for just a month's copay. Most of the programs allow patients to enroll and order online. The downside is that patients who are taking medicines for chronic conditions have to be organized and order ahead to make sure they don't run out of their medicines before the next shipment arrives.

"This is a good thing we always recommend to people," said Paula Evans, a clinical pharmacist and MassMedLine counselor. "For many families, that's the way to save a lot of money."

Consult patient assistance programs. There are a number of programs that provide free or low-cost medicine to low-income people who are uninsured or under-insured. Most are funded by pharmaceutical companies. One website recommended by MassMedLine that offers a comprehensive directory of patient assistance programs is RxAssist - www.rxassist.org.

"If a patient is approved for this, they will often be approved for help for six months to a year, until the patient finds his way," Sullivan said. "The manufacturers do look at this on a case-by-case basis, and we have seen significant help provided to folks."

The downside is that the process can be confusing and cumbersome, so Sullivan doesn't recommend it for people who have health insurance. MassMedLine will help consumers with the application process.

One other helpful website is NeedyMeds, www.needymeds.org. The site offers a cornucopia of inexpensive healthcare tips.

Explore Prescription Advantage. Prescription Advantage is a state-subsidized prescription drug insurance plan available to all Massachusetts residents age 65 and older, as well as younger individuals with disabilities who meet income and employment guidelines. Budget cutbacks have limited benefits, but the plan may still be helpful to cash-strapped consumers who qualify. Information and applications: 800-AGE-INFO.

Kay Lazar can be reached at klazar@globe.com.