Consumers Union recently found that almost a third of people surveyed, including asthma patients, said they had not filled drug prescriptions as directed. Some didn't submit the prescription to the pharmacy, and some skipped doses or cut pills in half without the approval of a doctor.
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If you stop taking your medicine, you could end up paying far more for emergency room visits and hospital stays than you would have paid for even the costliest drugs.
"Asthma drugs can be very expensive," says Dr. Eric Kleerup, clinical professor of medicine and an asthma specialist at UCLA Medical Center. "People with insurance struggle with them, people without insurance have a horrible time and the risk of hospitalization increases if you don't take meds."
That's not to say cost-lowering options aren't available. People with asthma should, for starters, follow the same basic advice as others who are trying to save money on drugs:
* Ask a doctor for samples.
* Ask him or her if a generic is appropriate. If so, find out if the drug is among the generics offered for as little as $3 or $4 per month at many pharmacies.
* Ask the pharmacist about any drug discount coupons on hand. Or look up discounts at www.internetdrugcoupons.com.
* Ask your doctor if you would do just as well on a different, less expensive drug or on one for which there's a discount offer or coupon. And don't be shy. Doctors know the economy has been tanking and won't be surprised by your questions. "We want to help keep you out of the hospital," Kleerup says.
* Find out if you qualify for free or reduced-cost asthma drugs through the Partnership for Prescription Assistance, www.pparx.org or (888) 477-2669.
But many asthma patients may have cost-lowering options that other people don't have, Kleerup says.
* Work harder to avoid triggers such as pets or seasonal allergens. Doing so might enable patients to switch to a less expensive drug or drop to a lower dose. Moving down a dose level for Advair, for example, can push the drug's cost from about $240 a month to $209 a month, based on drugstore.com prices.
* Reduce the need for the newly expensive emergency inhalers by using maintenance drugs as instructed. Earlier this year, many asthma patients took a hit to their wallets when the Food and Drug Administration retired older inhalers and required a delivery system that's safer for the environment. Unlike some older versions, available as generics for $5 or $10 per prescription, the new versions can cost as much as $60 per prescription. "But take your daily medicine and you could need less of the rescue drug and will have to refill it, and pay for the refill, less often," Kleerup says.
* Consider a less expensive, reduced-quantity supply of rescue medication. Sold by Walmart under the name Relion for $9 per prescription (a doctor has to prescribe it specifically), the version provides only 60 puffs, while the more expensive bottles contain 200 puffs. For some, this may be sufficient.
* Help your doctor determine whether you could be switched to a cheaper drug or a lower dose. Kleerup recommends tracking your symptoms, your maintenance drug use and your need for rescue medicine.
Asthma Journal, a free application for the iPhone, is available from ringful.com, a healthcare application developer. (It will be available for other mobile phones and devices next year.) Check www.ringful.com and click on the inhaler icon on the right of the home page. It lets you log triggers, symptoms and drug doses and e-mail the information straight to a physician. The app also offers asthma news updates, such as drug approvals and information about some clinical trials.