ULTIMATELY, YOU CONTROL YOUR DRUG COSTS
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You are the ultimate determinant of your drug cost. In this age, visits to the physician are frequently requests for medication. If your satisfaction with the physician depends on whether or not you are given medication, you are applying pressure against your own best interest. If you go to a physician because of a cold and request a “shot of penicillin,” you are asking for poor medical practice. Penicillin should infrequently be given by injection, and it should not be given for uncomplicated colds. Your physician knows this but may give in to your pressure.
The most frequently prescribed medications in the United States, making up the bulk of drug cost, are not scientifically important medications. Instead, they are tranquilizers, minor pain relievers, and sedatives. These prescribing patterns arose, in large part, because of ill-advised consumer demand. You can decrease the cost of medications by using some of the techniques above; you can eliminate them almost completely by decreasing your pressure to receive and utilize medications which you do not require.
REDUCING COSTS AT THE PHARMACY
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The pharmacy is another crucial factor in your drug expenses. For the most part, the pharmacist no longer weighs and measures individual chemical formulations. Much of the activity in the pharmacy consists of relabeling and dispensing manufactured medication. Medication is thus usually identical at different pharmacies; you should choose the least expensive and the most convenient. Comparison shop. Often discount stores will offer the same medication at significantly lower prices. 1£ a considerable sum of money is involved, you should compare prices by telephone before purchase. If a pharmacy won’t give you price information over the phone, don’t go to it.
Unfortunately, even though your physician writes a prescription by “generic” name rather than brand name, the pharmacist is not required to give you the cheapest of the equivalent alternatives. Often, the pharmacy will stock only one manufacturer’s formulation of each drug. Thus, even though your physician has been careful to allow the pharmacist to substitute a less expensive preparation, the pharmacist may not do so because only a more expensive alternative is in stock. There is no way to detect this problem except to get direct price quotes from different pharmacies.
The majority of pharmacies charge a percentage markup. Their pricing is determined by the wholesale price, multiplied by a fixed profit figure. A sliding scale may be used, but profit is largest on the largest sales. Other pharmacies work on a specific charge per prescription. These pharmacies take the wholesale price and add a constant fee. With a small drug bill, you will be better with the percentage mark-up formulas. If you are buying a significant quantity of expensive medication, application of the one-time fixed charge may be less costly. Knowledge of these problems and aggressive comparison shopping is essential for the consumer to control costs.
YOUR PHYSICIAN CAN SAVE YOU MONEY ON DRUGS
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Your physician plays a maj or role in the cost of drugs by choosing the drugs to be prescribed. For example, if you have an infection due to bacteria, you may be given tetracycline or erythromycin. Tetracycline costs about three cents a capsule, while erythromycin costs about twenty-five cents. If you are given a steroid prescription for asthma, at the physician’s option this may be prednisone at two cents per tablet or methylprednisolone at twenty cents per tablet. Medically, such drug choices are between agents of similar effectiveness. If your physician prescribes a drug by its trade name, in most states the pharmacist must fill the prescription with that particular brandname product. The brand-name product frequently has a cost many times that of its “generic” equivalent. Does your physician know the relative cost of alternative drugs? Many doctors do not.
The drug-prescribing habits of different physicians can be divided into two groups: the “additive” and the “substitutive” prescribers. With an “additive” physician, each visit you receive a medication in addition to those which you already have. With a “substitutive” prescribing physician, the medication you were previously taking is discontinued and a new medicine is substituted. Usually, the “substitutive” practice is advantageous to your health as well as your pocketbook.
Most of the time, medication can be taken orally. The common reason for requiring medication by injection is the physician’s uncertainty that you will take the medication as prescribed; by injecting it, the medication certainly has been taken. As a thoughtful and reliable patient, however, you can assure your physician of compliance with an oral regimen. Taking medication orally is less painful, less likely to result in an allergic reaction, and far less expensive. There are exceptions, but you should seek oral medication when possible.
If it is clear that you must take a medication for a prolonged period, ask the physician to allow refills on the prescription. With many drugs it is not necessary to be charged an additional physician visit just to get a prescription written. Under other circumstances, the physician may wish to examine you before deciding whether the drug can be safely continued or is still required. Ask your physician if refills on the prescription are permitted. The careful physician will ensure that you fully understand each drug that you are taking, the reasons you are taking it, the side effects which may possibly arise, and the expected length of time that you will be taking the medication. A medication schedule will be arranged during the day so that it is convenient as well as medically effective. 1£ the program is confusing, ask for written instructions. It is crucial that you understand the why and how of your drug therapy. Do not leave the physician’s office for the pharmacy without understanding your medications.
Reducing Your Medication Costs
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Legal drugs are a multibillion dollar industry. Your contribution to this industry is largely voluntary. The size of the contribution is determined by your illness, your physician, your pharmacy, and yourself. Drugs are life-saving, dangerous, curative, painful, pain-relieving, and easy to misuse. Also, they are basically poisons. Drugs interact with other drugs causing hazardous chemical reactions. They have direct toxic reactions on the stomach lining and elsewhere in the body. They cause allergic rashes and shock. They are foreign chemicals with severe toxic effects when taken in excess. Under some circumstances they probably cause cancers, and some drugs decrease the ability of the body to fight infections.
If you do not receive a prescription or a sample package of medication from your physician, consider this good news rather than rejection. Prefer to take the fewest possible drugs for the shortest possible time. When drugs are prescribed, take them regularly and as directed, but expect that your medication program will be reviewed, thoroughly, every time you see your doctor.
Most drugs are given as “symptomatic medications,” that is, they do not cure your problem, but attempt only to give some relief for the symptoms of that problem. If you report a new minor symptom every time you see your physician, and urgently request relief from the symptom, you will probably be given additional medications. You are unlikely to feel much better as the result of the extra medications, and you are nearly certain to function at a lower level as a human being. Unless you have a serious illness, you seldom should be taking more than one or two medications at a time. Perceptive observers have argued that the present practice of using drugs to control symptoms is only a temporary phase in the history of medicine