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(Editor's Note: This is the first in a three-part series of articles on trimming your personal health care spending.)
Dec. 9, 2008 -- In these tight economic times, people are looking for ways to stretch their money. But when it comes to your medications, some cost-cutting strategies make sense, while others may be penny wise but pound foolish.
Here are expert dos and don'ts for cutting drug costs without compromising your health.
Many people "think they should be on brand-name medications," says Adam Goldstein, MD, MPH, professor of family medicine at the University of North Carolina Medical School.
But Goldstein tells WebMD that, with very rare exceptions, generic options are OK. For example, researchers recently reported in The Journal of the American Medical Association that heart disease patients typically do as well on generic drugs as on brand-name drugs.
That can be a way to make your pills last longer and for you to save money.
Ballantyne explains that high and low doses of drugs often cost the same amount. So getting a higher dose and cutting the pills in half could make your pills last twice as long.
For instance, Ballantyne says a patient who takes 20-milligram doses each day of a drug that costs $100 per month could save $600 a year if his doctor prescribes a 40-milligram dose and the patient cuts each pill in half.
Some pills don't work properly if they're split, warns Joel Zive, PharmD, vice president of Zive Pharmacy in the Bronx, N.Y. and spokesman for the American Pharmacists Association.
"Splitting pills is not necessarily a bad thing to do," says Zive. "It depends on the drugs." Your doctor or pharmacist can tell you if splitting your pills is an option.
This strategy is another way to make your pills last longer.
"A lot of folks are taking medication twice a day, and it may be actually cheaper to get a higher dose and take them once a day," Goldstein says.
"Physicians are very open to the issues if someone is having financial problems," says Ballantyne.
Goldstein agrees. "A lot of my patients are being real frank about things they can afford and cannot afford," he says. For instance, he says some patients have told him, 'I can only take three or four medications; which ones should I take?'
"That's when we really have to turn to nonpharmaceutical ways of managing the issues," Goldstein says.
Zive suggests asking your pharmacist, privately, about costs. "You say, 'Look, I'm having a problem. Can you help me out a little bit with this?' and sometimes they can; sometimes they can't. ... it doesn't hurt to ask."
For instance, Zive says at his own pharmacy, "if somebody has an issue with a co-pay and they get paid at the end of the week, I say no problem, I'd rather you take this medication and you pay me in a few days, or I'll give you a couple pills now and you can come back."