A new doctor tried to put me on Advair a few years ago. I took the sample and tried it for a month. When I went to the pharmacy, I found out it was $250 a month (I had no Rx insurance at the time), I went straight back to the doctors office. She had no idea how much the drug cost without insurance! We argued for 15 minutes, because I refused to take such an expensive medication that only marginally improved my peak flow. Fortunately, my old doctor, a man I’d worked with for 10 years, was around and backed me on my decision.

I recommend that people with long term diseases educate themselves medications and what they do. If you have a better idea of what each medication is supposed to be doing, you can better manage your disease. In the case of asthma, I’ve focused on medications that prevent attacks (Singular and Zyrtec), rather than taking bronchodilators (albuterol etc.) and steroids daily. I keep albuterol on hand for emergencies, but I’ve found that an inhaled steroid isn’t really necessary. I would do better on it, but only marginally better than I currently am and that isn’t worth an extra $25, or my twice monthly burrito night.

I switched from an extended release med to instant release to reduce the cost, $50 difference on that one alone.

I’m growth hormone deficient, but I can’t afford that medication and the “bridge” program at Pfizer that claims they will help the underinsured? Ha. Ha ha ha. They do not return my calls.

I Google the prescription drug and see if the company offers me an incentive. I take Nasonex for allergies and signed up for their newsletter — now I get $10 coupons in my email to help offset the cost of the prescription copay. Many drug companies offer similar incentives.

I also transfer my prescriptions between just two competing pharmacies. My family’s prescriptions are for chronic conditions (asthma, allergies) and the odd antibiotic, so I feel safe that I won’t have a problem with drug interactions by filling at the other pharmacy. Rite Aid and CVS both occasionally offer prescription coupons for transfers (and new ones much less rarely) in the $25-$30 range. One time my sister was cash poor and didn’t have the money to fill a prescription for her son. I’d just filled an rx for me using the coupon, so I had a $25 gift card that covered her copay. She used a $25 coupon too on the new prescription and actually came out ahead for once! I don’t recommend this for anyone who takes a laundry list of medications or often changes their meds.

Many chain pharmacies, Wal-Mart, Target, etc. offer generics for $4.

Also, one thing I learned the hard way is to definitely ask the cost first. If you get an uber cheap antibiotic, the cost can be less than your copay. But some pharmacies will fill it under your insurance and charge you your first tier copay anyway. Sometimes cash is king and not using your insurance can save you a few bucks.