AIDS TREATMENT NEWS No. 064 - September 9, 1988
Denny Smith and John James
Usually mail-order pharmacies are close to each other in price -- as would be expected, since geography doesn't matter and customers can easily call and compare. They consistently have good prices, but not always the lowest.
At community pharmacies (not mail order), prices can vary greatly. We found that cities like New York and San Francisco usually had the highest prices, while smaller cities like Nash- ville had the lowest. This variation suggests that persons in big cities may save the most by filling their prescriptions by mail.
But individual pharmacies often have surprisingly low or high prices for a particular drug. (And an earlier survey of five pharmacies in San Francisco, mentioned in AIDS Treatment News #52, found some price variations as much as 50 percent or more for the same drugs in the same city.)
Generic drugs -- chemical equivalents of brand-name products for which patents have expired -- can offer the biggest savings; prices are often a fraction of those charged for the name brand.
The most extreme price differences we found were for Septra DS. You could pay $154.65 at one pharmacy. Or you could buy a generic equivalent by mail for $11.19.
Are the less expensive drugs as good? Few doctors insist on the more expensive brand-name drugs. Ask your doctor if he or she knows any reason not to use a generic equivalent.
Mail-order pharmacies are poorly regulated at this time, and some critics have claimed that they may be more likely than others to make errors in filling prescriptions. Since errors are possible in any case, you might check when refilling a prescription to make sure that the pills look the same. If you want to check the first time you receive a medication, the Physician's Desk Reference, available in most public libraries, includes color pictures of prescription drugs.
Some legal requirements can vary by state. In some states, if the patient wants a generic drug the physician may have to specify that on the prescription. In others (including California), a pharmacist may substitute a generic equivalent (with the patient's consent), unless the physician writes "do not substitute" on the prescription; these days few physicians do. In these states you can get the generic (if one is available) by asking the pharmacist for it, even if you did not bring up the matter with your physician.
Another legal technicality to note is that California and some other states prohibit refilling an out-of-state prescription. Therefore if you are using an out-of-state pharmacy, you will probably have to send a new prescription each time, even if you could otherwise just ask for a refill. Watch your drug supply to avoid running out; most physicians will mail you a new prescription when necessary, and then you can mail it to the pharmacy.
The great price differences suggest that it would be wise to check prices at several pharmacies, including at least one mail-order pharmacy, before spending much money for prescription drugs.
The Pharmacies
We did not select the pharmacies in this survey systematically; we either picked ones we knew about, or we asked PWA organizations to suggest one in their city. While the pharmacies selected this way are probably better than average, there are many others which we did not consider. All those we did call were helpful and cooperative.
The two pharmacies selling by mail were Family Pharmaceuti- cals of America (800/922-3444), and Huntington Plaza Pharmacy (818/397-3072). The seven others were The Apothecary (Bethesda, MD, near Washington, DC), Bigelow (New York), Corsons (Philadelphia), Ike's (Nashville), Kaiser (San Francisco), Pay'n Save (Seattle), and Walgreen's (Minneapolis).
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