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How to Reduce Your Prescription Costs and Avoid the "Donut Hole"

Expert Author Mary Sue McAslan

At this time of year many Medicare recipients find themselves in the "donut hole" or the gap between what Medicare will pay for medication coverage and what the individual will have to pay for on their own.

The way that Medicare works is that it covers up to $2,700 yearly in prescription costs. Then Medicare coverage stops. The coverage only starts back up again if the prescription costs exceed $6,100 in that particular year. This means that the drug costs between $2,700 and $6,100 are paid for by the individual himself.

What You Can Do to Lower Your Medication Costs and Avoid the Doughnut Hole

Generic Drugs

One of the most important steps that you can take to lower your drug costs is to use a generic drug. A generic drug is the same as a brand name whose patent has expired. The generic and the brand name are the same drug chemical. The generic drug is sold under the chemical name. For example, Zestril® is the brand name for lisinopril and Pravachol® is the brand name for pravastatin.

Generic drugs cost much less than the brand name drugs and work the same way. Additionally, there are many pharmacies that now offer many generic medications for only $4.00 each month. This is a very big savings and will help to decrease your drug costs. Ask your doctor or pharmacist if your drug is available as a generic and if this is right for you.

Lower Cost Alternative Medicines

Many doctors prescribe lower cost drugs instead of the higher cost, newer drugs. These are not the same identical drugs, but are very similar in effect. For example, if you need a drug for your cholesterol, your doctor may prescribe a newer drug costing $150.00 each month. Alternatively, your doctor may prescribe a lower cost, similar drug that would only cost $25.00 each month. By using the lower cost drug, you are saving $125.00 each month or $1500.00 a year.

Lower cost drugs are available for many different medications. These include drugs for cholesterol, high blood pressure, depression and stomach ulcers. Additionally, these drugs may even be available on the $4.00 generic list saving you even more money!

Ask your doctor or pharmacist if there is a lower cost alternative drug to your high cost medication.

Over-the-Counter Medications

There are many medications that are now available "over-the-counter". These drugs do not require a prescription. They are available on the drugstore shelf. These drugs include Prilosec®, Prevacid®, Zyrtec®, Claritin® and others.

It is very important that you check with your doctor and pharmacist before making a change to an over-the-counter drug. They will tell you if this is right for you.

Drug Promotion and Advertising

We have all seen the TV and magazine adds promoting drugs for high cholesterol, high blood pressure, bone loss, depression, insomnia, etc. Many people see these ads and go to their doctors requesting the drug that they saw on TV. Typically these drugs are new and very expensive and do not work any better than the older drugs. Do not pressure your doctor into prescribing a drug that you saw on TV. Your doctor is the expert in your healthcare and knows what is best for you.

There are several ways you can lower your drug costs and stay out of the "donut hole." These are 1) use a generic drug, 2) use a lower cost alternative drug, 3) use an over-the-counter drug and 4) don't fall for drug advertising.

As always, your doctor is the expert in your medical care. This article is not meant to take the place of your doctor's advice. Always check with your doctor or pharmacist about your medications. Your doctor and pharmacist know what is right for you.

Mary Sue McAslan, Pharm.D.
America's Family Pharmacist
DrMarySue@americasfamilypharmacist.com
http://www.americasfamilypharmacist.com

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