My eyebrows went up when I read recently about a North Carolina insurance program that saved $6.6 million over a three-year period through prescription drug "cost-control interventions." Individuals covered by the plan saved, too. Their average monthly drug expenditures dropped by about 11%, from $11.52 to $10.23 per prescription.

The study, published in The American Journal of Managed Care, was led by David P. Miller, Jr., MD, assistant professor at Wake Forest University School of Medicine in WinstonSalem, North Carolina. The study focused on the university medical center's own health insurance plan, which covers more than 22,000 people.

The bulk of the savings came from prescribing generic instead of branded drugs—an option that is becoming more widely available.

Popular medications that have recently become available in generic versions include the antihistamine Allegra (fexofenadine)...the sleep aid Ambien (zolpidem)...the heart drug Coreg (carvedilol)...the herpes/shingles drug Famvir famciclovir)...Lamisil (terbinafine), which treats nail fungus...the cholesterol-lowering drug Zocor (simvastatin).. and the antidepressant Zoloft (sertraline).

Pharmacists are your best source of information about new generics. They also can tell you which ones are not yet available legally. Some Internet suppliers sell what are purportedly generic forms of drugs that are still under patent protection.

Examples: Drugs such as Lipitor (atorvastatin), a cholesterol-lowering drug, and Viagra (sildenafil) do not have generic equivalations.

People with prescription drug coverage save with generic drugs because co-payments are lower (typically $10 versus $25 or more). Savings can be much more substantial for people who lack such coverage and for Medicare recipients whose annual drug expenses are approaching the infamous "doughnut hole," when no drug costs are covered.

Good for everyone: Some large chain stores, such as Target and Walmart, now charge only $4 for a 30-day supply and $10 for a 90-day supply of any of hundreds of generic drugs.

More ways to save…

  • Buy OTC. In the study, medications were moved out of the insurance formulary (the list of drugs that an insurance plan covers) if there were comparable over-the-counter (OTC) drugs available. Dr. Miller says that consumers, especially those without prescription drug coverage, may indeed save in two particular categories the nonsedating antihistamines, such as Claritin (loratadine), and the acid-reducing proton pump inhibitors, such as Prilosec (omeprazole). In some cases, even if a person has insurance, the cost of the OTC drug still may be lower than the co-payment. Ask your physician which medications may help you the most, and then compare costs.
  • Split pills. Because many medications are priced about the same regardless of dose, buying a double-dose pill and halving it gives you two pills for the price of one. Check with your pharmacist to make sure that a pill can be split safely. Pill-splitting devices can be purchased in drugstores and on-line for less than $10.
  • Avoid drugs altogether. In this study, the plan limited the quantity of sleep aids supplied to members. Members were provided with only enough tablets for every-other-day use, instead of the usual 30-day supply. Because sleep medications can have serious side effects, including daytime drowsiness and slower reaction time, Dr. Miller urges people with insomnia to try to restore a healthy sleep pattern without medication, whenever possible

Bottom line: If you eat right, exercise regularly and guard your health in other ways, you are likely to need fewer drugs altogether.

Prescription Drug Moneysaver

Get help paying for prescription drugs, health care, utilities and more. At BenefitsCheckUp (, sponsored by the National Council on Aging, older Americans can get information about more than 1,500 programs to help with health care, taxes, energy costs and more. Once you find a program, you can print out application forms or apply on-line for benefits.

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