SUPERSTAR DRUGS DEBUT AS GENERICS

A dose by any other name works as well and costs less.

DESIGNER labels may excite fashionistas and sports-car fanatics, but many consumers are happy to stock their medicine cabinets with less-expensive generic alternatives to brand-name prescription drugs. Value-conscious shoppers will soon be able to pick from a bumper crop of generics. And they'll get a boost from insurers and employers who offer financial incentives to hop on the cut-rate bandwagon.

Assuming your doctor okays your switch to a generic alternative, you may save up to 80% off the cost of a brand-name drug. For example, a year's supply of the antidepressant Prozac costs $1,863. But the same amount of its generic equivalent, fluoxetine, costs just $433, according to a recent price survey by research firm Wolters Kluwer Health. "You get all the premium quality of a brand-name drug--you just pay less," says Dr. Bill Thomas, a Sherburne, N.Y., physician who specializes in elder care.

If drug coverage is included in your health insurance, you probably have a smaller co-payment for generics. Some employer plans even skip the co-pay altogether for generics, as a way of encouraging their members to switch to less-expensive alternatives. If you don't have prescription-drug coverage, buying generics will help you hold the line on out-of-pocket expenses.

Coming soon. What if your prescription medication isn't available in generic form? Wait a bit. Brand-name drugs with U.S. sales of about $30 billion could lose patent protection over the next two years. Five blockbuster drugs--Flonase, Pravachol, Toprul-XL, Zocor and Zoloft--went generic in 2006, and eight more pharmaceutical superstars are expected to debut as generics by 2008. As a result, consumers, employers and insurers could save nearly $50 billion by 2010.

Joan Zeleski has already grabbed her share of savings by switching to generics. The 51-year-old nurse used to take Desyrel for insomnia and paid $45 for a three-month supply. By switching to the generic version, she saves $56 on the same amount.

For convenience and the employee discount, Zeleski buys prescriptions from her hospital's pharmacy. Most people don't have that option, but they can still save by shopping around.

Wal-Mart rolled out a headline-making generic-drug program in 27 states late in 2006. Under the program, you can buy a 30-day supply of more than 140 generic drugs for just $4 per drug. The world's largest retailer says it plans to bring the discount program to as many states as possible. Drugs on Wal-Mart's $4 list include 12 of the top 20 most commonly prescribed medications. And you don't need insurance coverage or a discount card to qualify for the savings.

Other retailers also offer competitive pricing. Target says it matches Wal-Mart's generic-drug prices in most locations. Midwestern discount retailer Meijer fills prescriptions for some antibiotics, such as penicillin, free.

Savings tips. Finding the best deal on generics sometimes takes a little detective work. A Family paying for five common generic drugs could save more than $2,000 a year on top of the savings over brand-name medications just by looking for the best deals, according to a survey of generic-drug prices by Consumer Reports.

Check prices both in stores and online. Consumer Reports found that big discount stores, such as Wal-Mart and Target, and online pharmacies affiliated with drugstore chains, such as CVS.com, tend to charge the least. Costco warehouse stores and Costco's Web sire had the lowest generic prices in the survey. And you don't have to pay Costco's $50 membership fee to fill your prescriptions. (For more on Costco and other warehouse stores, see page 102.)

Drug prices vary depending on how much you buy and in what form. Tablets, for example, could be cheaper than capsules. And a 90-day supply may cost less than the typical 30-day prescription. Ask your doctor for a prescription you can buy in bulk, and talk to your pharmacist about the cheapest and safest form of each medication. With some medicines, you might save by buying large pills and splitting them into smaller doses. But check with your doctor or pharmacist to see if pill-splitting is appropriate for your prescription.

Don't be shy about asking your pharmacy if it can meet or beat a competitor's price. You might get a bargain and save yourself the hassle of moving your business elsewhere.

North of the border. Sure, you can save up to half the price of brand-name drugs if you buy from pharmacies outside the U.S. But importing medications from any foreign country except Canada is illegal In Canada, purchases must be made in person with a valid U.S. prescription approved by a Canadian doctor.

That legal exception does not extend to buying Canadian drugs over the Internet. It's illegal to order drugs from Canada online, but U.S. Customs and Border Protection says it will no longer routinely seize packages of non-narcotic prescription drugs mailed from Canadian pharmacies. It will, however, continue to conduct random searches for counterfeit medications.

Some consumers, particularly those who rely on brand-name drugs that do not have generic alternatives, think the savings available on imported drugs is worth the risk. If you are considering this route, shop only at Canadian pharmacies and Web sites, says Steven Findlay, managing editor of Consumer Reports But Buy Drugs. There's less chance of getting ripped off with fake drugs or endangering your health with weak or tainted medicine, Findlay says.

Some Canadian sites have been vetted by state governments and scrutinized by federal regulators. Minnesota, New Hampshire, Washington and Wisconsin, for example, have started programs to help state workers and other residents buy low-cost drugs from Canada (go to www.rx.wa.gov or www.minnesotarxconnect.com).

But it's not worth the trip just to buy generic drugs. "People aren't going to Canada to save $6," says Stephen Schondelmeyer, director of the PRIME Institute, which studies the economics of the pharmaceutical industry.

ONLINE PHARMACY

For Web resources to help you compare prices and medications, see kiplinger.com/links/drugs.

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By Thomas M. Anderson

AVERTING A BIG OOPS

Privacy cracks can happen in unexpected ways. New tools can avert costly slipups

A patient e-mails your hospital for directions to the outpatient department. Not much of a Health Insurance Portability and Accountability Act issue there, right? What if he also writes that the visit is to discuss his HIV test results?

For large health systems with sophisticated systems to secure electronic files and communications, such an exchange may not pose a problem. "The challenge we have in health care is, what about everybody else?" says Bill Crounse, M.D., director of provider business for Microsoft Corp. "Eighty percent of health care is delivered in settings that aren't large integrated systems."

HIPAA requires that hospital risk managers, IT directors and others who handle health information--including e-mail and instant messages--apply reasonable and appropriate safeguards to protect against disclosure.

The law sets stiff penalties for infractions. It has been a daunting task that's kept many providers from using the efficiency of e-mail to communicate with patients. Now, technology that prevents breaches of privacy without bogging down communications and workflow is becoming more available.

Winona (Minn.) Health uses an "e-visit" software module from Cerner Corp., Kansas City, Mo., that allows patients to log on to a secure Web site to communicate with their doctors. Others use encryption programs to secure e-mail, such as a program from Eastman Kodak Co.; group purchasing firm Consorta Inc., Schaumburg, Ill., offers it to members.

Microsoft says its newest e-mail offering, Outlook 2007, will allow users to put postmarks and expiration dates on e-mails and it can restrict e-mails from being forwarded or printed.

St. Peter's Hospital, Helena, Mont., uses a sophisticated program to scan and electronically monitor all outgoing e-mails for protected health information.

"We have filters in place to monitor e-mail activity--who's sending what and where they're sending it," says Daniel Sullivan, director of information services. "But if you're asking me if we're 100 percent sure nothing left the building, I can't go there."

Until recently, tools that meet HIPAA's privacy requirements have been clumsy and difficult to use. But tech advances now make it easy to manage e-mail communication transparently, says David Smith, a senior compliance analyst with Symantec Corp., the Cupertino, Calif., provider of security products such as Norton AntiVirus.

"Transparency has been the real dragon to slay. If the user has to take even one additional step, such as encrypting a message, it just didn't happen," he says. "Now it's built into these technologies and the user may not even know it's there."

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By Richard Haugh