If your insurance has ever stopped covering a prescription drug or you don't have coverage at all, you know how quickly costs can mount. Americans spent, on average, $758 out of pocket for medication in 2012, according to a Consumer Reports national telephone poll. In its survey of 1,130 people who regularly took prescription drugs -- both the insured and uninsured -- 12 percent spent more than $1,200 last year.
Consumer Reports' advice if you're looking to reduce out-of-pocket drug costs: Shop around.
Its secret shoppers recently called more than 200 pharmacies throughout the U.S. to get prices on a month's supply of five blockbuster drugs that have recently become available as generics: Actos (pioglitazone), for diabetes; Lexapro (escitalopram), an antidepressant; Lipitor (atorvastatin), for high cholesterol; Plavix (clopidogrel), a blood thinner; and Singulair (montelukast), for asthma. The result? A whopping difference of $749, or 447 percent, between the highest- and lowest-priced stores.
Costco was the least expensive overall, and you don't need to be a member to use its pharmacy.
A few independent pharmacies came in even cheaper, though their prices varied widely, as did grocery store pharmacies. The online retailers Healthwarehouse.com and FamilyMeds.com also had very low prices.
On the other end of the spectrum, CVS, Rite Aid and Target had the highest retail prices.
A representative of CVS told Consumer Reports that its retail drug prices reflect other services offered by the chain, including drive-through windows, automated prescription refill systems, free outreach programs to help make sure patients are taking their prescriptions correctly and 24-hour pharmacies. Costco pharmacies, the cheapest overall, are open from 10 a.m. to 7 or 8:30 p.m., and are typically closed on Sundays.
Whichever drugstore or pharmacy you use, choosing generics over brand-name drugs will save you money. Talk to your doctor, who may be able to prescribe cheaper alternatives in the same class of drug.
In addition, follow these tips:
* Request the lowest price. Consumer Reports' analysis showed that shoppers didn't always receive the lowest available price when they called the pharmacy. Sometimes they were given a discounted price, and other times they were quoted the list price. Be sure to explain -- whether you have insurance or not -- that you want the lowest possible price. The shoppers found that student and senior discounts may also apply, but again, you have to ask.
* Leave the city. Grocery store pharmacies and independent drugstores sometimes charge higher prices in urban areas than in rural areas. For example, Consumer Reports' shoppers found that for a 30-day supply of generic Actos, an independent pharmacy in Raleigh, N.C., charged $203. A store in a rural area of the state sold it for $37.
* Get a refill for 90 days, not 30 days. Most pharmacies offer discounts on a three-month supply.
* Consider paying retail. At Costco, the drugstore websites and a few independents, the retail prices were lower for certain drugs than many insurance copays.
* Look for additional discounts. All chain and big-box drugstores offer discount generic drug programs, with some selling hundreds of generic drugs for $4 a month or $10 for a three-month supply. Other programs require you to join to get the discount. (Restrictions apply and certain programs charge annual fees.)
Although the low costs found at a few stores could entice you to get your prescriptions filled at multiple pharmacies based only on price, Consumer Reports' medical consultants say it's best to use a single pharmacy. That keeps all of the drugs you take in one system, which can help you avoid dangerous drug interactions.