Internet pharmacies can provide big savings for people who need prescription drugs. Prices average 18% less than even discount retail store prices. For some drugs, the savings are as high as 45%.

How it works: A patient orders a drug online. The patient or his/her doctor sends a written prescription to the Internet pharmacy. A pharmacist reviews and fills the prescription, which then is shipped through the mail.

Many over-the-counter (OTC) products are available at Internet pharmacies, too. Most Internet pharmacies also accept phone orders if you do not have computer access...or you can go to your library and use the computer there.

The convenience and savings of Internet pharmacies have led many patients to abandon brick-and-mortar stores-but you must make sure the pharmacy is reputable and shop wisely to get the best deals. Here's how...

Look for the VIPPS seal. Internet pharmacies that advertise themselves as Verified Internet Pharmacy Practice Sites (VIPPS) have been inspected by the National Association of Boards of Pharmacy (NABP). NABP evaluates participating pharmacies on the quality and consistency of their procedures.

Caution: Some unscrupulous Internet companies display the VIPPS seal even though they have not been inspected. Check a company's status at Some reputable pharmacies, such as AARP's and Costco's, are not VIPPS members-be sure you are familiar with the company's reputation.

Check insurance participation. Most Internet pharmacies work with a limited number of insurance companies. Some bill the insurers directly...others do not.

You can find this information on the pharmacy Web sites or you can call your insurance company to find out which, if any, Internet pharmacies are part of its network.

Figure in extra costs. Some Internet pharmacies offer free shipping for standard ground delivery. This usually takes two weeks, so order well in advance. Fees for overnight delivery can be high.

A few Internet pharmacies, such as AARP's, charge patients annual membership fees. If you need many prescriptions over a year, the savings can more than offset the extra fee.

Buy in bulk. Some insurance companies allow people to get a three-month supply of medication for a single copayment when they order from Internet pharmacies, cutting costs by 67%.

Patients can also save by buying up to a year's supply at a time.

Example: One man ordered a year's supply of the thyroid hormone levothyroxine. He skipped his insurance company entirely-and still saved $80.

In addition, some pharmacies offer free shipping on big orders.

Pick a company that has a "live" pharmacist. Avoid any Internet pharmacies that don't provide customer support. Look for one that has a pharmacist available to answer questions, either via E-mail or telephone.

Ask a pharmacist. Some drugs, such as the anticoagulant warfarin and the heart drug digoxin, are sensitive to extremes in temperature and so can degrade while they are in the mail. Ask the Internet pharmacist whether your medications can withstand the rigors of mail travel before ordering on the Internet.

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