There’s an old saying: there’s no such thing as a free lunch. When it comes to saving money on drugs, that’s not always true, but it’s close enough – you may have to work for the savings. A lot of the time, you can find a less expensive alternative just by asking your physician or pharmacist whether there is one, but sometimes it helps to do your own work so that you can ask specific questions about lower cost drugs or alternative treatments. This may be difficult – it means reading material intended for professionals – but with drug prices what they are, there may be a generous reward at the end. The best approach might be to have a niece or nephew who is a physician or pharmacist, but if you don’t have one available, you may have to do your own studying. Unfortunately, some of the best resources come with high price tags, so it might be worthwhile to get to know the reference librarian at your local library. You may find some helpful information in the non-professional resources, but too often these are dumbed down and don’t offer the sort of information you need to make an informed comparison between drugs. They may be good for a start, but if you want to have a serious discussion with your physician, you’ll need some better resources.

Two wonderful, but pricey resources are Facts & Comparisons (http://www.factsandcomparisons.com) and Martindale’s Extra Pharmacopoeia (http://www.medicinescomplete.com). Both organize drugs by class, so it’s easy to compare drugs within a group, and learn whether a new drug has a work-alike that’s available as a generic. Of the two, Facts & Comparisons is easier to use, because it provides exactly what the name promises. Each section has charts that compare drugs within a class, so it’s easy to see if one drug has really major advantages or disadvantages compared to others. While the price is high, they publish a relatively reasonably priced annual hardbound edition that might be in your library, and if you do have a medical or pharmacy student in the family, they offer a free one-year subscription.

For free information, there may be nothing better than the drug information at Medscape (http://www.medscape.com) This resource uses information provided by First DataBank and AHFS Drug Information published by the American Society of Health-System Pharmacists. While Medscape is probably best suited for finding out information about individual drugs, it is possible to find a list of the drugs in a class, and which ones are generically available. Since the entries include both the patient information hand-out and the professional version, you can start with the patient information for a basic understanding, and then move up to the more detailed information.

Another wonderful and free resource is DailyMed, which is provided by the United States National Library of Medicine (http://dailymed.nlm.nih.gov). This too is a reliable source of information, but not designed for comparison shopping. Like Medscape, DailyMed provides both professional and non-professional information, which can be useful, since too often drug information for non-professionals is over simplified. The patient information can be a good introduction to the topic, then move up. The National Library of Medicine also offers a medical dictionary and other resources to help with parts that are difficult to understand.

People who have prescription drug insurance should be sure to look at ePocrates (http://www.epocrates.com), since this site has a unique feature – information on the formulary status of the drugs in its database. With this wonderful resource, your physician can see whether a drug is covered by your insurer, and pick one that is, so that you don’t get sticker shock in the pharmacy. ePocrates offers some information as a free download, and charges for other material, but the information you need to save money is free.

For people who need help, the Pharmaceutical Manufacturer’s Association (http://www.phrma.org) has links to patient assistance programs. A number of other sites also offer guidance regarding these programs, which can really help people who can’t get help by any other means. These programs are run by the drug manufacturers to assist people who can’t afford to pay for their medication. The requirements of the various programs are individualized, but find out what’s available. There’s a personal note to this. In past years, I was on the panels of one or two pharmaceutical companies, reviewing their patient assistance programs. We, the panelists, kept making recommendations that would make it easier, not harder, for patients to request and get assistance with drug costs, and the company went along with our recommendations. These patient assistance programs can be really helpful, and are worth exploring when things get rough. Be aware, though, that each company offers assistance in paying for its own drugs – they won’t offer help paying for generic medicines. But it’s worth it to look up the rules.

Also, while it’s usually best to stick with a single pharmacy and fill all your prescriptions in one place, some people can’t afford that luxury, and have no choice but comparison shop. Several states have set up web sites with comparison prices for pharmacies – but these sites may not be reliable. Last February, the Washington, D.C.-based Center for Studying Health System Change examined prescription comparison shopping sites operated by ten states: Connecticut, Florida, Maryland, Michigan, Minnesota, Missouri, New Hampshire, New Jersey, New York and Vermont. They found that most states had serious flaws in their methods that led to missing or outdated information. Only New York actually asked the pharmacies for their prices, and only New Jersey reported the date the price was obtained. Maryland only listed 26 drugs. So, these sites may be of limited value, but at the current price of gasoline, saving on miles can mean as much as saving on medication.