Pocketmint

small change toward a rich life
31
July
2012

Don’t buy drugs from a drugstore

A few weeks ago, I mentioned that we were resorting to anti-anxiety drugs in an attempt to cure Sammy and reclaim our house from the plastic and pee.

I already budget $25 per month against veterinary care for all three pets. Part of that covers their annual checkups and any necessary shots; the rest serves as a sort of targeted emergency fund for any pet-related medical issues. But we are still running on a tiny income, and any dollar I can save is a dollar we can use somewhere else. So lately I’ve been all about the veterinary frugality.

annoyed cat with pill bottle on headWhen I was researching pet anxiety online, I’d read that one of the most frequently prescribed medications was buspirone. This was convenient, because I happened to have a bunch of leftover buspirone from a prior prescription for myself. (I am a prescription pack rat, and although sometimes I take this too far, it occasionally pays off.) We had enough to last, at cat-level doses, for many months.

I figured you can’t get much more frugal than free. But as much as I love getting medical information off the interwebs, I figured that before I started giving my own leftover drugs to my cat it would be prudent to run this plan by my real-life vet. So I left a message for her to call me.

No response. A few days later, I tried again, in the middle of one of her three scheduled days in the office. The receptionist told me that she had left to take her daughter to the hospital. Yikes, okay.

Mind you, I’m kind of attached to my regular vet. She’s hilarious, for one thing. And I trust her. Some medical professionals will sit confidently atop their experience and existing knowledge in every situation. Others aren’t afraid to seem less than perfectly omniscient, and when faced with something unfamiliar, will take the opportunity to learn more. My vet is one of the latter. Her willingness to say ‘not sure, let me find out and get back to you’ means that when she does speak confidently about something, I can trust what she says. All my favorite doctors — for both pets and people — have shared this characteristic.

But with my regular vet off at an emergency and not expected in the office again for several days, I somewhat reluctantly agreed to talk to another vet in the clinic whom I’d never met. She told me that since fluoxetine — aka Prozac — had gone generic, they usually led with that, but there was no reason not to try buspirone since I had some. I confirmed what I’d read about the dosage and latency period — all correct. The Internet had not led me astray.

cat biting girl's noseWell, we gave it four weeks, but Sammy’s symptoms — including the teeth-grinding and the peeing outside of the box — did not abate. Worse, I think he started to resent me for the twice-daily pill-down-the-throat procedure, despite the fact that I gave him a treat after each one: during that last week he began to bite. Never during the actual pilling ritual, but just randomly at other times during the day, he’d walk up and nip my knee or calf or whatever other body part he could reach. Just me, too — he never once bit Jak, who had been all too happy to stay out of the whole process.

As we waited to see if the buspirone would help, I had actually been working on another veterinary issue, this one regarding an intestinal condition in both cats. Without going into too much detail, I was working with my vet to get a special kind of test that their labs don’t ordinarily use, but one that is more reliable for the particular problem I believe our cats have, and about an order of magnitude cheaper. More good veterinary frugality, thanks to Internet research!

In the meantime, I’d learned that my vet’s teenaged daughter has Crohn’s disease. Dealing with hospitals and doctors has clearly taken a lot of her time and attention, and the result was that it sometimes took several messages and once a full twelve days to actually get her on the phone.

pill bottle, cat fluoxetine prescriptionI did finally make contact with her last Monday night, though, and got her to sign off on a prescription for generic Prozac. Here’s where I made my first mistake: I didn’t think to check prices at various pharmacies before I had her on the phone. Mostly because I hadn’t realized that Prozac would come from a people-pharmacy; every other prescription had been dispensed right from the animal hospital.

It’s been a couple of years since I filled a prescription at a local pharmacy even for myself; I’ve been using mail order or my HMO dispensary. So when my vet asked where to call with the prescription, I picked a nearby Walgreens, thinking that I remembered that Walgreens was one of the drugstores that had adopted the $4/$10 pricing scheme for common generics that Wal-Mart had pioneered several years ago.

My memory was dead wrong. Walgreens, as it turns out, offers cheap generics only if you buy a $20 annual ‘discount card’ first. I arrived at the counter last Tuesday to be told that my prescription was not $4, but $16.69. $18.28 with tax. And that was for only 20 pills, not a full 30. Dammit!

What I should have done at that point was say ‘no thanks’ and walk away. Go home, call the vet’s office, and ask for a new 30-pill prescription to be sent to a different pharmacy, one that I’d confirmed would offer the $4 price. Result: 50% more pills for fourteen fewer dollars. 92 cents per pill vs. 15 cents: I was being gouged.

sign: chat lunatiqueBut by now it had been five weeks since I first got desperate enough to drug my cat in the first place, and emotionally, the difference between having Prozac in hand right now and having to wait some unknown period of additional time was just too great. Crazy cat is wearing me down, and I really need him to be less crazy, like, yesterday.

I paid the extra $14. And I’ve been annoyed at myself ever since. Because realistically, walking away would have meant losing a day or two at most. Even if my vet wasn’t available, any of the other four doctors could have called in the prescription just fine. But in the moment, I couldn’t think all of that through.

So here we are, one week into the (needlessly expensive) Prozac trial. Fluoxetine takes a minimum of two or three weeks to show improvement, and it will be eight weeks of no change before we can reasonably assume it isn’t going to work. But since he only takes 1/4 of a 10mg pill per day, 20 pills is enough for us to find out one way or the other.

If fluoxetine does work, and I need to get more pills, I’m prepared: Fred Meyer and QFC (both owned by Kroger) offer 30 pills for $4, no ‘discount card’ required.

If you’re looking for the cheapest generics near you, here’s some help to get you started:

Walmart, Target, and all of the many regional grocery chains owned by Kroger offer $4 generics, along with a number of other regional groceries like ShopRite and Great Eagle. (There is evidence that Safeway, and Safeway-owned Dominick’s, used to have a $4 generic drug program, but they seem to have quietly eliminated it.)

Oddly, drugstores seem to be the worst place to go for drugs. Walgreens requires that $20 annual fee, and even then may not match the $4 price (30 fluoxetine pills cost $5). RiteAid doesn’t charge a fee but does make you register and then charges $10 for a 30-day supply. CVS doesn’t seem to guarantee any particular price on generics, nor do they offer a way to check prices online.

And now you must excuse me; I have to go pill a cat.

Tip

8 responses

Subscribe to the RSS feed for comments on this post.

  1. Miki says

    In case the meds aren’t a good fit, I will say that I’ve had excellent results with these pheromone collars:

    http://www.amazon.com/Sentry-Behavior-Pheromone-Collar-Inches/dp/B0026JAKWG/

    $10/month is still more expensive than the pills had been for us, but that has been well worth it for the improvement in quality of life — not only from how well the collars have worked, but from not having to deal with pilling these cats! :p

    • Karawynn says

      Hi Miki, thanks for the tip. I skipped pheromones mostly because the scientific studies I found showed that pheromones were vastly less effective than meds, and, well, we were in a hurry. Fluoxetine is supposed to have a ~95% success rate, as compared to ~40% with pheromones.

      I am seriously hoping that something works soon, because right now it’s like living under siege. :/

  2. Julia says

    Thank you for this post! I had no idea about the $4 generic pricing at any of those stores, and have almost always just gone to CVS because… that’s what my family has always done. I was, however, extremely grateful to an urgent care doctor who let me know that I she was prescribing me a particular antibiotic because I could get it for $1 at Meijer (I’m in MI).

    I hope that the meds help Sammy!

  3. KBK says

    I know we are speaking on animals here, but if you live in a city that has a Publix Supermarket they give out FREE antibiotics. That’s right: FREE. Has saved me I don’t know HOW much money over the years.

    • Karawynn says

      I only found out about the free antibiotics when researching this very post; I still haven’t found a source local to me, although various regional chains in other parts of the country seem to have adopted the practice: Publix, Meijer, ShopRite, Giant Eagle.

      My response to this information was mixed, because I know that over-prescription of antibiotics — leading to resistant bacterial strains — is already a problem, and I fear that making them a loss leader will only hasten the day when none of our antibiotics work any more.

      Here’s an MD writing on Consumer Reports with the same concern: http://news.consumerreports.org/health/2009/01/free-antibiotic.html

      Ultimately, I believe physicians need to hold the line, even if their patients are badgering them for an inappropriate prescription. But I also have read enough studies in the field of behavioral economics to know that people respond very differently to FREE vs (miniscule cost), and for that reason I would rather see a two-week course of pills cost $1 (as Julia’s comment above suggests they once did) than be utterly free.

  4. Margaret Durocher says

    Rite Aid charges 14.95 for a 3 month supply of generics, so if you can get your doctor to give you a 90 day prescription, it works out to $5.00 a month. Cheaper than my insurance deductible!

    • Karawynn says

      Yes, it often doesn’t make sense to even use insurance for prescriptions if there’s a viable generic on the market. I suspect a fair number of people haven’t realized that, and buy them through insurance mail order on autopilot.



content & design © karawynn long