Dollars & Health: Cashing in on generics

You hear a lot about drug prices going up and up, but consider the case of Ann Stewart of Mattapan, Mass., who faced a price of $146 for her diabetes medicine. After a transfer of prescriptions, she's now paying $4. And then there's financially strapped Glenn Funchess, a cancer patient in Rochester, N.Y., who got the cost of his medications drop by $300 a month.

And finally, there's me, a supposedly savvy health care journalist, who took months to realize that taking a different cholesterol drug would cut the co-pay by $50.

These savings came from switching from brand-name drugs to generics. An increasing number of prescriptions are generics – now 70% of the total filled. They cost up to 90% less than brand names, and for some, it can make the difference between taking a medication -- or skipping it because it's unaffordable.

To take advantage of these bargains, you should be pro-active about prescriptions, and here's how you can do it:

Many consumers still perceive that a brand name is best. Generics – copies of brand names whose patents have expired -- have the same active ingredients as the brands, same effectiveness, same dosage, same safety. They're approved and regulated by the same Food and Drug Administration. So you get the same bang for considerably fewer bucks.

Consumer awareness rose when Wal-Mart in 2006 began offering a 30-day supply of many generics for $4. Target and other retailers followed with similar promotions. "That has been a big plus for consumers,'' says Marcia Hams of Community Catalyst, a consumer advocacy group.

During an office visit, let your physician know if you prefer generics when they take out their white pads. "A physician is very likely to pick a brand name because they have samples in their office, or because they just had a free lunch,'' says Dr. Edward Jardini, a Templeton, Calif., family doctor who wrote the book How to Save on Prescription Drugs.

Doctors are bombarded by drug companies' multibillion-dollar marketing, anything from free takeout to multicolored ballpoints. Yet Dr. Phil Mohler, a family physician in Grand Junction, Colo., says that industry influence on doctors is waning.

Many physicians know little about a drug's price, but during this recession, ''every doc should be thinking about cost,'' says Mohler, who writes the Prudent Prescriber newsletter for Rocky Mountain Health Plans. As for patients, he says, "In a restaurant, I would like to know what I'm going to pay for a meal I'm going to order.'' You should have the same menu idea at the pharmacy.

So if your doctor recommends a brand, ask if there's a generic for it. And if there's no generic equivalent, ask if there's a medication in the same drug class that can work as well.

Jardini, for example, notes that cholesterol-lowering statins have a big price difference: A generic can cost $200 less than a brand for a three-month supply.

There are some differences between drugs within a class. And a doctor has to always consider side effects, Jardini says. "I would never change any treatment that's effective for the patient,'' he says. If a patient is stabilized on a brand-name psychotropic drug, for example, it may not be a good idea to switch, Mohler says.

Also, while you may be tempted by free drug samples, that option generally leads to a brand-name script, which ultimately could cost more.

Drug pricing information is available on websites such as Best Buy Drugs from Consumer Reports and drugstore.com.

Andy Miller is an Atlanta-based freelance journalist who has written about health care for 17 years.