Drugstore, retail chains offer generic medicines at discounts

Win-win scenarios can be rare in the field of medicine.

A new surgical procedure might cure something but be found years later to have caused even worse problems. A new wonder drug might dramatically alleviate the symptoms of something but years later be discovered to have caused unrelated problems nobody even imagined.

So how refreshing is it to see a health care trend that everybody can agree is a slam-dunk plus for both patients and doctors?

The trend in question: Programs offered by several retailers and pharmacy chains that give consumers significant discounts on generic prescription drugs.

The programs are available through a roster of retailers that includes Walgreens, Target, CVS, Walmart and Costco. Using them, value-conscious consumers who are willing to do a bit of comparison shopping can purchase generic prescriptions for just a few bucks a month.

The potential benefits can be huge. According to a 2010 report by the U.S. Centers for Disease Control and Prevention, the percentage of Americans who said they took at least one prescription drug during the previous month increased from 44 to 48 percent over the past decade.

During 2007-2008, the study added, one out of five children and nine out of 10 older Americans said they used at least one prescription drug during the previous month.

However, the CDC report also noted a harsh reality: Americans who didn't have a regular place to obtain health care, didn't have health insurance or had no prescription drug benefits used fewer prescription drugs than those who did.

Enter the discount generic prescription programs, which began appearing on the country's retail landscape during the mid-2000s. While the specifics vary from retailer to retailer, all offer consumers the chance to purchase specific generic drugs at potentially significant discounts.

Target, for example, offers a 30-day supply of specified generics for $4 and a 90-day supply for $10. Its program is open to anybody, and there is no fee to join.

CVS' Health Savings Pass program has an enrollment fee of $15. Members then pay $11.99 for a 90-day supply of their generic medication, and also receive a 10 percent discount on services at MinuteClinic health clinics located inside select CVS stores.

Walgreens' Prescription Savings Club also has an enrollment fee - $20 a year for an individual and $35 a year for a family - and then a three-tiered plan for generic drug purchases ($5, $10 or $15 for a 30-day supply, and $10, $20 and $30 for a 90-day supply). Members also receive discounts on immunizations and in-store clinic services and on Walgreens-branded products.

Jay Bernstein, product manager, product development and innovation, for Walgreen Co., says the company's program was designed for consumers who have no prescription drug coverage of any kind. However, he adds, participants also include "a lot of folks who are underinsured" - for example, those whose prescription drug plans have high co-pays.

Walgreens' plan covers more than 8,000 generic prescription drugs, Bernstein says, "so just about every generic is covered in the program."

The specific generics offered under the plans vary by retailer. However, each offers prescription medications to treat such common ailments as asthma, high cholesterol, hypertension and arthritis.

How can the companies afford to offer generics so inexpensively? The short answer: volume.

Iain Buxton, chairman of the University of Nevada School of Medicine's pharmacology department, says national retail/pharmacy chains such as Walmart or Walgreens can purchase generics in large quantities and, thus, can receive "tremendous deep discounts" from manufacturers.

Then, the companies can pass their savings on to consumers as a means of bringing customers into their stores, where consumers might choose to purchase other items, too.

Walgreens' Bernstein says his company created its discount prescription plan primarily because "it helps our patients," particularly the uninsured. But, also, he says, "we want to promote loyalty among our patients."

Physicians see no downside in making prescription medications more affordable for consumers. Dr. Mitchell Forman, dean of Touro University Nevada College of Osteopathic Medicine, says the plans do seem to offer potential benefits for most patients.

That's particularly true for low-income consumers and seniors. Nevada AARP spokeswoman Deborah Jaquith notes that about one-third of Nevadans age 65 and older live solely on Social Security, and that Social Security makes up 50 percent or more of income for almost 60 percent of Nevada seniors.

Even for consumers who qualify for prescription assistance through Medicaid or seniors who have supplemental prescription Medicare benefits, a savings of even a few dollars a month can go a long way toward not having to choose between purchasing a needed prescription or paying bills.

The programs "do offer generics for good prices," Jaquith says. "Generally, there are pretty good values."

Marvalyn Hogan, a retired administrative assistant, purchases her prescription drugs through Costco. Hogan, who lives on a fixed income, says the warehouse retailer's prices tend to be significantly lower than those of other pharmacies, which helps her stretch her budget.

Hogan does pay an annual Costco membership fee. But, she continues, "for example, I'm on this blood pressure medicine, and I think I paid $5 for 30 (pills). I don't think you can get that too much cheaper anywhere else."

Aiding in the programs' acceptance is a dissipation of the suspicion with which generic drugs were greeted a few decades ago.

"When they first came out, there was a great deal of resistance," Buxton says. "A lot of physicians would not write (prescriptions) for them."

However, Buxton says, generic drugs must be proven to federal regulators to be equivalent - in their composition and in the way they work - to their brand-name counterparts.

Today, he says, "your ability to trust the generic drug that is made by a reputable firm - your ability to trust the generic - is as good or better than your ability to trust the new drug that's just been developed and put on the market."

For physicians, making low-cost generics available to consumers has a clinical dimension: Forman notes that patients who can't afford to purchase a prescription medication may not purchase it, or may take it in ways - skipping days to stretch out a month's supply of drugs for high blood pressure, for instance - that could compromise their health.

Dr. Mahfoud Beajow, a physician with Internal Medicine Associates, says, "If a patient has to choose between (buying) food and medication, they're not going to be compliant with my recommendations.

"I want to make sure they have enough money for food, and if they can save money on medicine, at least I can help them with that. So every prescription I write, I need to have a reasonable idea that the patient will be able to afford it."

For consumers, taking full advantage of a discount prescription drug program begins in the doctor's office.

Buxton says, "When you see your physician and you're getting a new prescription ... you should ask the physician, 'What are you going to give me, because I would prefer a generic if one is available.' "

Patients shouldn't hesitate to tell their physicians if they can't afford a brand-name drug or, even, a comparatively expensive generic. Only then, Forman says, can the physician and patient consider more affordable alternatives.

"In fact, I try to be proactive, as I'm sure most of my colleagues are, in addressing that practical question," Forman says.

(By the way: Consumers who can't afford to purchase a medication at all should talk with their physicians about pharmaceutical company programs that offer no-cost prescriptions to eligible patients. As a physician, Forman says "that's my job to know about that.")

Consumers then can research their prescription medicines through such resources as the AARP's drugs and supplements fact page (http://www.aarp.org/health/drugs-supplements). Also, the AARP Rx Drug Savings Tool (http://drugsavings.aarp.org) breaks down estimated prices of brand-name drugs versus their generic counterparts.

Consumers then should research whether the specific drugs they, and their families, take are offered by each plan. An Internet search via an online search engine also can provide basics of each plan, including its pricing structure and, if applicable, the fee to join.

What if the drug you're taking isn't on the plan you'd like to use? Again, talk to your doctor, who, Buxton says, probably can find an alternative generic medication that will be on your desired plan.

For consumers who have no prescription drug coverage, a head-to-head comparison of each plan will be straightforward enough. However, consumers who do have prescription drug coverage also might calculate the cost of purchasing a drug via their co-pay versus the cost of paying for the same drug out-of-pocket through the discount plan.

Also, Forman suggests: If a consumer finds a lower price somewhere else for a prescription medication, "go back to your current pharmacy and ask: 'Can you match this price?' Sometimes they will if they want to keep your business."

Finally, once you do choose a pharmacy, use it for all of your prescription and over-the-counter drugs.

"If possible, the patient should establish a relationship with (one) pharmacy," Buxton says. "And the most important part of that relationship is the ability of the pharmacist to know what else the patient has been taking."

If a patient obtains prescriptions from more than one pharmacy, the ability of the pharmacist - and of the pharmacy's computer software - to detect potentially dangerous drug interactions will be lessened.

"Looking at interactions between drugs is a critically important thing. Knowing someone's allergies is a critically important thing," Forman says. "And you're much less likely to see those kinds of errors when you shop at the same place."

Contact reporter John Przybys at jprzybys@reviewjournal.com or 702-383-0280.