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Clever way to cut the cost of medicines

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Saving dollars, saving lives: the affordability of medicines has been shown to affect how regularly patients take them

Making medicines more affordable is important for improving patient health — even those who have prescription drug insurance.

According to one study, heart attack patients who didn’t have to pay a lot for their medicines were more likely to get their prescriptions filled and take their drugs correctly. As a result, they were less likely to have repeated serious heart problems.

Generic medicines are copies of brand-name drugs that are less expensive. They contain the same active ingredients and are subject to the same government rules about strength, quality, and purity. Studies showed that people who take generic medicines are more likely to stay on them than more costly brand-name medicines.

Additionally, guidelines for clinicians recommend that they prescribe generic medicines for their patients if possible, rather than brand-name ones. However, not all medicines are available in a generic form.

How much can you save by buying generics?

On average, a 30-day supply of a brand-name prescription medicine costs about $250 a month without insurance coverage. A prescription filled with a generic drug costs about $25 to $50 a month. The price of generic drugs varies from one drugstore to another. To get good prices you may need to check with a few different pharmacies.

Why do generic medicines cost less than brand-name drugs?

When drug companies develop a new medicine, they spend a lot of money studying it, testing it and then advertising for it. In exchange for that initial investment, they are allowed to have a “patent” on their new medicine, giving them the exclusive right to sell it for the first years it is available. When the patent expires other companies can come out with generic copies of the medicine. Makers of generics can charge less because they do not have to pay for developing or advertising the medicines. With time, and with multiple companies competing to make the same generics, the cost goes down even lower.

Are generic drugs as safe and effective as brand-name drugs?

Yes. US FDA-approved generic medicines meet all of the same requirements for quality, strength, purity and shelf life as brand-name medicines. Rarely, switching from a brand to a generic copy could cause problems for a small number of people with certain conditions. This could include people who have difficult-to-treat seizures or thyroid problems, or who take organ transplant medicines.

How should you switch to generic medicines?

• Whenever your doctor prescribes a medication, ask for the generic version. In many cases, pharmacies will automatically give it to you, if it is available.

• If the exact medicine does not come in a generic form, it is often possible to take another one that can treat your condition just as well and that is sold as a generic.

• Some medications are sold as brand-name only because they contain two or more medications in one pill. It may be possible to take the individual preparations, in separate pills, as low-cost generics.

• Some popular prescription medicines, for example Nexium, Prilosec and Zantac, are now available at a lower cost, over-the-counter, without a prescription.

Can splitting pills save me money?

Some prescription drugs cost the same, no matter what strength the pill is. As a result, it is sometimes possible to get a prescription for double the strength you need and cut the pills in half. That way, you get your medicine at about half the cost. It is not safe to split ALL medicines; check with your doctor or pharmacist.

Capsules and extended-release should NOT be split. Always use a pill splitter; never use a knife. Beware of free-trial offers on brand-name medications as they do not provide a long-term solution, because the drug company can stop the coupons or offer anytime.

Beware of foreign or internet-only pharmacies. They sell what sound like really good deals but be careful — especially with any pharmacy that offers to sell you medicines without a doctor’s prescription — the FDA has found that some of them are not properly licensed and inspected. Plus, they may sell you medicines that are not right for you or expired ones or less powerful versions or even fake pills.

Joe Yammine is a cardiologist at Bermuda Hospitals Board. He trained at the State University of New York, Brown University and Brigham and Women’s Hospital. He holds five American Board certifications. He was in academic practice between 2007 and 2014, when he joined BHB. During his career in the US, he was awarded multiple teaching and patients’ care recognition awards. The information herein is not intended as medical advice nor as a substitute for professional medical opinion. Always seek the advice of your physician. You should never delay seeking medical advice, disregard medical advice or discontinue treatment because of any information in this article.

Expert advice: Joseph Yammine (File photograph by Akil Simmons)