If it seems like prescription medication prices have risen nearly as fast as Bitcoin once did, you’re not that far off. And it isn’t just with exotic drugs. Examples: In recent years, the price of the heart drug digoxin, one of the oldest drugs on the market and historically very cheap, has been raised more than 600%…and the cost of ­insulin has tripled.

But there are strategies to control your drug costs so that you can afford what you need…

 Use Discount Apps and Sites

One of the few positive trends in the pharmaceutical business in recent years has been the rise of websites and apps that let you easily search for the lowest prices on prescription medication. None of these services accept insurance, but the prices offered are sometimes even lower than what many people would pay through their insurance plans.

Here are some of the best online drug discount programs (all are free to join)…

GoodRx. Print coupons for discounts or send them to your phone, and then show them at your pharmacy to save up to 80%.

RxPharmacyCoupons.com can save you up to 90% on more than 20,000 name-brand and generic meds at more than 68,000 pharmacies.

BlinkHealth. Buy your prescription at a discount online, then pick it up at your local pharmacy.

Many drug manufacturers also offer discount coupons. Search online for “discount coupons” and the name of the drug you need. These may not be usable along with your prescription drug coverage, so check with your plan.

Let Competition Work for You

You might be surprised to know that prescription prices can vary widely at different pharmacies—even within the same pharmacy chain. Before filling a prescription, call around to compare the price at your local mom-and-pop pharmacy and at nearby locations of major chains. This simple step can save you a bundle if you’re paying cash or haven’t met your drug plan’s ­deductible.

Extra tip: Large-chain drugstores, such as CVS, Rite Aid and Walgreens, and large stores with pharmacies, such as Walmart, Costco and Target, are engaged in a price war over which one can charge the least for some of the most common generic drugs—so call around and take advantage when you have such a prescription to fill. Target, for instance, offers the antibiotic amoxicillin, the diabetes drug chlorpropamide and the prostate drug doxazosin for just $4 a month each (or $10 for a three-month supply). Sam’s Club fills some generic prescriptions for free for members. Keep in mind: Many chains offer drug discount cards, so sign up for them.

Negotiate with Your Pharmacy

Most people think drug prices at pharmacies are fixed—but often they’re not. Simply asking, “Is that your best price?” over the phone or in person is sometimes all it takes to get a discount. A good pharmacist may match a price you find online or search for discount programs or coupons that you can use to reduce the price. It can’t hurt to ask—even at big pharmacies.

Use a Mail-Order Pharmacy

If you are taking a medication to control a chronic condition long-term, there’s no need to drive to the pharmacy or reorder every month. Mail-order pharmacies—and perhaps even your local one—deliver a 90-day supply to your door and can be set up to auto-refill prescriptions. And it’s not merely convenient—it’s often cheaper because you pay one dispensing fee for 90 days’ worth of a drug, rather than one fee per month. People who have drug plans with participating mail-order pharmacies typically save as much as one-third compared with using a local pharmacy.

Caution: There are lots of unscrupulous businesses online that present themselves as legitimate pharmacies but that are not. Don’t gamble on whether you will receive legitimate medicine. To ensure that you’re getting the correct prescription when you buy drugs online, use only mail-order retailers that display the “VIPPS” symbol on their websites. This means the site is accredited by the Verified Internet Pharmacy Practice Sites (VIPPS) program from the National Association of Boards of Pharmacy. If you want to see whether an Internet pharmacy is accredited, you can look it up online at NABP.pharmacy/programs/vipps. An example of a good VIPPS-accredited mail-order pharmacy is ­HealthWarehouse.com. It does not take any insurance, but it’s worth comparing prices with those you can get through your insurance plan—you might save money.

Grill Your Doctor

Physicians are like the rest of us when they have a shiny new toy. When a promising new drug hits the market, they are likely to get excited and prescribe it instead of older alternatives. But what if the cost of this new name-brand drug is 10 times that of a time-tested generic or five times that of an older brand-name drug that might be equally effective? Your doctor might not consider the price difference.

Of course, if your condition requires a newer drug for which there’s no cheaper equivalent, you should pony up. But whenever your doctor wants to prescribe you a new drug, make sure that you truly need it by grilling him/her about the pros and cons versus older drugs.

The Danger of Using Multiple Pharmacies

While shopping around can cut your drug costs substantially, there is one potentially large drawback to purchasing your meds in multiple places—dangerous drug interactions. You might have multiple doctors prescribing you different medicines, with no one doctor knowing about everything you take. You should discuss with each of your doctors all the medications you take…but another line of defense against harmful drug interactions can be a pharmacist.

My advice: Make sure that each place that fills a prescription for you enters every med you take into its ­record on you…even meds that you get elsewhere. Ask a pharmacist to review this complete list every time you add a new prescription. This act of drug due diligence takes only a few extra minutes, and it will help ensure your safety.

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