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Looking to save on prescription drugs? It’s complicated

Struggling to pay for your prescription medication? You’re far from alone. Studies show a quarter of patients don’t take medicines they need because they can’t afford them.

There are plenty of ways to save, but the complexity of finding the best deal can be a huge headache. Along with assistance programs, there are countless coupons and discount cards. Prices change often and vary dramatically so it’s often difficult to compare. Here are some guidelines.

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For starters, when a doctor is about to write a prescription, jump in with key questions:

Are free samples available? Is the drug generally covered by insurance? Is there a cheaper drug that will work as well, or a generic version?

An unprecedented number of drugs have recently begun to face generic competition. That includes the cholesterol fighter Lipitor and blood thinner Plavix. Once multiple generic versions hit the market, they are often priced as much as 90 percent below the brand-name’s cost.

 A patient assistance program may help. They generally have income limits and other eligibility rules, but some are generous, particularly for newer drugs for cancer or rare diseases. Drug makers almost always offer help; check websites.

The industry’s Partnership for Prescription Assistance, at www.pparx.org, directs uninsured patients to free or nearly free drugs.

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Advocacy groups focused on one disease often can help, too. The Patient Advocate Foundation, at www.patientadvocate.org , helps patients find copayment assistance and deal with medical debt and related problems. Government-subsidized clinics provide prescriptions for free or at a discount.

 If you don’t qualify for help:

Target, Kmart, Walmart and large grocery chains offer widely used generic drugs for $4 to $10 a month.

If you’re insured, don’t assume your plan offers the best price. Some high-volume discounters, such as Costco, offer great deals for cash-paying customers, particularly on generic drugs.

Coupons from makers of brand-name drugs typically offer a first prescription free, or $50 to $100 off for a few months or more. Also, check out Internet pharmacies but avoid sites that don’t require a prescription. That’s illegal and they may be selling counterfeit drugs.

Scores of discount cards are available online, generally for free. Most are good for a variety of medicines, including generics, but each card could offer a huge discount on one drug and only a couple dollars or nothing off another.

The pharmacies provide discounts to remain competitive, particularly with cards offered by huge groups such as AARP. Prices are negotiated by third parties such as benefit managers that already work with a huge network of pharmacies, says consumer advocate Edgar Dworsky. Still, do as much comparison shopping as possible.

Linda A. Johnson writes for the Associated Press.

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