You may be able to cut prescription costs by opting for a higher dose and splitting the pills.

Smart shopping strategies can help you save a lot of money on your prescription bills—without sacrificing your health. Here, experts' top tips.

You may be able to cut prescription costs by opting for a higher dose and splitting the pills.

You may be able to cut prescription costs by opting for a higher dose and splitting the pills.(ISTOCKPHOTO)

1. Follow your formulary
Your formulary is a list of prescription medications covered by your health-insurance plan. Drugs are organized into tiers with different co-pays, from $10 or so for generics to much higher amounts for some name-brand drugs. You should also check the generic co-pay against its retail price; sometimes your co-pay can actually be higher than simply buying the generic retail.

Because formularies vary from policy to policy, the patient can really help himself by showing it to the doctor, notes Edward Jardini, MD, a family physician and the author of How to Save on Prescription Drugs: 20 Cost-Saving Methods. The formulary can usually be downloaded from your insurance company's website or requested by phone.

2. Go generic
If you didn't have your formulary with you at the doctor's office, or you don't have a prescription plan, ask your doctor or pharmacist if there is a generic equivalent or a similar medicine that may be available as a generic, advises Sarah Ray, a spokesperson for the American Pharmacists Association. Generics, which are legal copies of brand-name drugs whose patents have expired, use the same active ingredients, are shown to work the same way in the body, and can cost a fraction of their brand-name counterparts. Theyre less expensive because generic manufacturers don't have the investment or marketing costs that new drugs require.

While generics are available at all pharmacies, certain generics are also available at mass retailers including Target, Wal-Mart, and Kmart for very low prices. (Target and Wal-Mart offer a 30-day supply of generics for $4 or a 90-day supply for $10; Costco charges $10 for 100 pills for most generics; and Kmart charges $10 or $15 for 90 days' worth.) It's worth checking to see if your drug is on any of their lists. Be careful, though, advises Vibhuti Arya, a spokesperson for the American Pharmacists Association; the megastore prices for brand-name medications can be higher than normal, possibly making the total price of your medicine needs higher than average.

Other lower-cost options you should ask your doctor about are older drugs that might be just as effective (but less expensive) or a less-expensive version of a drug thats in the same class.

Resources you can use to help you look for generic and other low-cost alternative medications are available at Rxaminer and Consumer Reports' Best Buy Drugs Guide.

3. Shop around
When one of Dr. Jardini's patients was checking prices for generic Prozac, he was quoted amounts of $153, $125, $119, $80, and $41 for a 30-day supply at five local drugstores. It pays to compare prices at websites, too. For instance, the cheapest prescription for a 30-day supply of 20-milligram capsules of generic Prozac at DestinationRx, a website that compares prices at online pharmacies, was recently $4, while the least expensive option from RxUSA was $12.

As of 2007, 10 states (and counting) were maintaining websites to help consumers compare drug prices at in-state pharmacies. A list of states with these price-comparison sites is available in a 2008 report by the Center for Studying Health System Change.

If you need more than one medication, make a list of all your medicines and their doses and find out the total cost for your entire list at a variety of pharmacies and websites; pick the place that offers the best deal on your total medicine package, rather than getting one medicine here and another one there. It is important that all your drugs ultimately come from the same pharmacy, so the pharmacist there has all of your information and can advise you if one of your medications will interfere with another, Ray says.

4. Split your pills
"If there's the same co-pay for a higher strength medicine, you can split the pill in half and save money," points out Arya. Ask your pharmacist if the medicine is suitable for splitting, since some medications—particularly time-delivery drugs—are not. Invest in a pill cutter (available at drugstores for a few dollars) to ensure an accurate dosage.

5. Buy a three-month supply
Usually, it's less expensive to get a 90-day supply instead of buying one month at a time, says Ray. For instance, a 30-day supply of 5-milligram tablets of simvastatin, a cholesterol medicine, costs $18 at, while a 90-day supply costs $43, saving you about 20% over the long term.

However, if it's a new prescription you just started, Ray recommends just getting one month's supply at first. If the doctor decides to change your dosage, "you may be stuck with pills you can't use."

6. Review your meds
If you take more than a couple of drugs on a regular basis, schedule periodic review visits with your doctor to reevaluate each medication, advises Dr. Jardini. You may find that some are superfluous or are not working anymore and can be discontinued. He cites one patient, a breast cancer survivor, who was taking Fosamax, which slows bone loss. But studies show that while there are still some benefits to taking the drug for more than five years, staying on it past the five-year point did not decrease patients' number of fractures. His patient discontinued it, saving herself a considerable cost. You cant always rely on your health-care providers to call you in for a consultation to alert you to such changes, so be proactive about asking your doctor to review your medication on a regular basis.

Also, ask a pharmacist if your drugstore offers medication therapy management, which will reappraise your entire medication list, make sure you need all of them, and recommend less expensive options, says Arya.