Anyone who takes medication on a regular basis runs the risk of overpaying. Your pharmacy will have little reason to suggest cost saving measures. After all, that will affect your bottom line. It is up to you, the patient, to be proactive in finding an affordable drug regimen.

Here are the top 10 reasons you may be paying more than you need for your medications:

1. You don’t know your form. If you have insurance, you have a form, whether you know it or not. A formulary is a list of drugs that your insurance covers at various price levels. Some medications will cost significantly more than others. Your doctor cannot be sure to prescribe a formulary drug for you unless you bring your formulary drug list with you to your doctor’s appointment.

2. You don’t know your options. There are always options. Although your doctor may suggest only one, when cost is a concern, be sure to ask about the least expensive options, as well as the pros and cons of each. You may find that the so-called best option costs 5 times more for a 5% higher profit.

3. You started with a drug that has seen price increases. It is not uncommon for a physician to start a patient on a profitable drug, only to discover years later that the cost has risen dramatically. Although initially you may have lost costs than a competing drug, over time the “playing field” changes. Costs can go up and other drugs can go generic. If you find that you are paying more and more, ask your doctor about changing your medication. Pharmaceutical manufacturers are well aware that if they can get patients to start taking their medications, they are likely to stick with it, even if the price goes up dramatically.

4. Continue with a brand name drug when a generic is available. Although insurance companies usually tell you about this, it is possible that you are accidentally taking a brand-name drug even though there is a generic one. As long as you are willing to pay, your pharmacy may not tell you either. If you’ve been taking a drug for a long time, it doesn’t hurt to ask your pharmacist if a generic may be available or on the horizon.

5. You go to a pharmacy with a higher profit margin. Pharmacies buy drugs at wholesale prices, but charge their customers the retail price. The pharmacy has the right to brand your drug as much as it wants, which sometimes makes a significant difference in what you pay – easily $ 20 for a brand name drug, from one pharmacy to another. Price shopping is the key to finding the lowest price.

6. You don’t buy in bulk. It is almost always cheaper to buy a three-month supply of a drug rather than buying a one-month supply three times separately. Pharmacies charge a dispensing fee to prepare your medicine bottle. You will pay this fee three separate times if you purchase your medication on a monthly basis rather than in three-month allowances.

7. You are taking a more expensive dosage regimen. For example, many drugs are cheaper if you take a higher dose once a day than a lower dose twice a day. Also, the most commonly used dosage strengths are generally the least expensive dosages. Ask your pharmacist if there is any way to change your dosing schedule to lower your cost.

8. You are taking a “cadillac” drug when a “pick-up” would work too. Doctors are often encouraged to use the latest and greatest, although yesterday’s best is almost as good as today. Ask your doctor if an older remedy is worth trying first.

9. You are taking medications that you do not need. Just because you needed a drug 5 years ago does not necessarily mean that you need it today. Ask your doctor to re-evaluate your entire medication regimen. This can take a good 15 minutes to discuss, so don’t try to add it at the end of a visit, when it might not be fully addressed. It would be best if you made a separate appointment for the sole reason of reviewing your medication options. Even if this costs you $ 100, you could easily make up that difference in a month or two by taking less expensive medications.

10. You are taking a higher dose of medicine than necessary. Again, although you may have needed a certain concentration of medications at first, as your disease becomes better controlled, you may need less. A good example of this is asthma control medication, such as inhaled steroids.

A little thought about your medication is a good starting point. Know the cost of each drug before discussing it with your doctor. Anyone taking more than one or two drugs will likely find a way to cut at least several dollars a month off their drug bill, which easily runs to a hundred dollars a year.

Copyright 2010 Cynthia J. Koelker, MD

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