Though many drugstores offer senior discounts, pharmacists may cut deals for those who bring all their prescriptions to one drugstore. If not, shop around and make sure you're getting the best price on a drug, even if it means filling prescriptions at several pharmacies. Gloria King walked around her neighborhood on the Upper East Side of Manhattan and found prices as high as $60 for a month's supply of Norvasc, a drug for high blood pressure, before discovering a pharmacy that would sell it to her for $43.
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Don't forget to check out the state drug discount programs for seniors who don't qualify for Medicaid, the nationwide health program for the poor. A new report from the Commonwealth Fund finds that state pharmacy assistance programs provide coverage for only about 3 percent of Medicare beneficiaries. But many of the programs at least provide the poorest of seniors with full prescription benefits. (Contact the local AARP or department of health for information.) And more than 30 states have some kind of pharmacy aid program to help seniors who aren't below the poverty level. California, for example, lets its Medicare recipients purchase drugs at an average discount of 20 percent.
While patients with very low incomes have long been able to get free drugs through programs set up by pharmaceutical companies, eligibility requirements are strict. But now there are new programs that reach a bigger crowd: the discount cards being promoted by pharmaceutical companies, drugstore chains, and organizations like AARP. While some ads promise that the cards reap impressive savings of 50 percent or more, most users will get discounts that are much more modest. In fact, the discount cards are far from perfect: Typically, they still include an income cap, discounts vary from drug to drug, and in some cases seniors need to carry a different card for drugs made by different companies. A physician can readily identify the manufacturers of each prescription.
North of the border. For those who despair of made-in-the-U.S.A. solutions, there is always the option of buying drugs abroad, where government-imposed controls keep prices low for some, but not all, medications. Drugstore.com sells 90 Fosamax pills for $184.56; RxNorth.com, based in Canada, sells the same thing for $138.74. Some people have friends in Canada send them medications, and others who live near the border make buying trips or use online pharmacies based there.
None of these steps will eliminate the drug coverage shortfall. Most experts agree with Albert Wertheimer, professor of pharmacoeconomics at Temple University, that "the optimal solution is an outpatient drug program attached to the Medicare program, administered in a uniform way." So far, though, there's no consensus on just how to achieve that optimal solution. With an election-year fight brewing, it may be every bit as important to know thy candidates this fall as it is to know thy health plan.
DRUG COST BITE
15 percent - Portion of healthcare dollars consumers 50 plus spent on prescription drugs in 1996
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