Yes, please be sure and check with your doctor first. ALSO check with a pharmacist before splitting ANY pills. Some cannot be split b/c it affects their efficacy and can even be dangerous if your skin comes into contact w/ the powder.

Yeah those XR/CR extended release tabs will mess you up if you go splitting them up. Good logical list though, lifestyle change and the non-treatment of side effects would be top on my list personally.

You could always grow your own and save BIG bucks...

Most traditional doctors will discourage patients from pursuing non-drug options.

Many studies (funded by major drug companies) discount the benefits of suplements and alternative care. These studies are promoted to the medical community to arm them to fight patient's attempt to find non-drug paths to health.

CBS headline "Vitamin E May Shorten Life".

Pretty scary and pretty convincing and blared throughout the traditional media who has a vested interest in not angering the drug company who spend a fortune on advertising.

What is not well publicized is that the study may well be total bullshit.

The author of the study, in the Journal of the American Medical Association (JAMA), concede that the "unexpected results cannot be confirmed at this time by other trials" and "could be due to chance."
[nutrition.about.com]

With the consolidation of media, it is impossible to get accurate health news and alternative medicine often does not result in a patentable treatment (asthma? drink more water) - so little research into non-drug therapies is performed.

One way out of our healthcare crisis is for our government to fund research into alternative treatments.

DO ask your doctor... if you know his prescribed medicine is not covered by your insurance, for example. I had a doctor that knee-jerk prescribed Cipro for every little infection. I asked her please to stop and give me something actually targeted for my infection and that my insurance would cover. She phoned a pharmacist, chatted for five minutes, and handed me a new prescription that worked better and was absurdly inexpensive.

Always check the side effects. I was on Lipitor which was covered by my plan. One of the side effects is hair loss. I was also on Propecia which was not covered on my plan.

FWIW: I still have a goodly amount of hair on my head.

@SkokieGuy:

"Most traditional doctors will discourage patients from pursuing non-drug options."

Bullshit. We would absolutely LOVE for our patients to eat right and exercise, it's just that it rarely happens. Contrary to what a lot of people believe, we really don't get kickbacks from the pharm industry (even pharm lunches have been taken away from most of us). Most of us prefer our patients to be on fewer drugs as studies show that increasing the number of drugs shows a positive correlation with a drug related incident.
As for the study regarding Vit E, don't believe the analysis of ANY study you hear about in the media. Most journalists haven't the slightest clue of how to separate good science from bad science and just choose the most sensationalistic option.

This list is insulting and 99% garbage! "Prevent disease naturally." How, by not fornicating with AIDS infected chimpanzees? Give me a break. "Cut costs by splitting tablets." Why, to take less than the prescribed dose?

My concern with generics is that many are manufactured in plants in China and India with little FDA oversight. The inspection budget for the FDA is tiny, the possibility of contaminated or counterfeit ingredients is strong.
[www.washingtonpost.com]

@wiggatron: Pills may be cheaper if they are sold in large dosages, like $5/25mg/pill vs $7/50mg, so you pay half if your doctor doubles the dosage and you split manually.

Then again, I heard somewhere that pharmacists have issues splitting pills correctly all the time anyway, so to expect someone who has a pill cutter to do an accurate job is pretty out there.

Most of the article can be summarized: talk to your doctor and have them re-evaluate which pills are necessary, telling them if something is ineffective, have side effects, etc. And don't go for drugs as the first choice. There should be a manual on how to be a good patient.

Wow - You mean, if it doesn't work and I don't need it, I shouldn't take it? Seriously, are you kidding? This list is crap.

Oh, and tell me what drug you can split and not effect the quality of?

A real tip that's not on there? Ask your physician to write you a 60 day supply as a 30 day supply (i.e., ask to write to take 1 twice a day, when you really only need to take it once a day) - You will get a 60 day supply for the same co-pay as a 30 day supply. Now that saves $$$!

Many manufacturers offer rebates on your out of pocket payment on non-generics (probably a way to stave off inevitable drug pricing reform). I'd recommend googling your drug name and "rebate" to see if yours are eligible.

@Cerb: Most doctors want patients to eat well and exercise but the ones I have been to (and my mother has been to) don't want patients taking fish oil to lower cholestoral or any other type of natural remedy.

@wiggatron: Yes, you can prevent disease naturally but, like medication and medicine in general, there are no sure things (or fixes). To help prevent AIDS, use a condom every time and don't fornicate with every willing person at the bar. Heart Disease: Exercise, watch what you eat, and take your fish oil. Etc. Etc. Sometimes a larger dose of a medicine is cheaper than a smaller dose, hence, split the pill.

@Cerb: Bravo to you and your practice. So when a patient comes in asking for (by name) Lunesta, do you recommend yoga or meditation first? Discuss their sleep hygiene? I mentioned not sleeping well to my (Blue Cross HMO) doctor and without a single question he wrote a Rx and gave me samples of two other drugs so I could experiement.

I can't tell you the number of doctors I've gone to who tell me supplements are a waste of money and will prescribe antibiotics at the drop of a hat, for crap like a cold to which antibiotics are at best, useless.

When my father came out of surgery for heart disease, the first meal he ate (ordered by the hospital dietician) was fried chicken, with mashed potatoes, gravy and jello.

@Cerb: I loved the semi-condescending lecture I got from my OB/GYN the last time I was there. Rather than asking me, he just assumed I eat like crap and don't exercise. (I am not overweight/overfat, either.) He also encouraged me to take a multivitamin and a fish oil supplement, because he apparently had no faith in my ability to eat fruits/veggies and fish. (I eat both regularly.) OTOH, I have sympathy for the doctors' whose advice to eat right and exercise falls on deaf ears. I'd probably just give up and rant about multivitamins after awhile too.

A great way to accomplish all the goals listed above, particularly #8 through #11 is to schedule an appointment with your friendly neighborhood pharmacist. Your insurance company will call this service Medication Therapy Management (MTM) and if you are on Medicare Part D it is covered. You can ask the pharmacist to suggest alternatives that are less expensive or that are on your insurance company's preferred formulary. Most will contact your doctor to facilitate any necessary changes.

I can understand splitting nonessential pills (i.e. pain pills), but given the fact that many pills are 'extended release', treat a life-threatening condition, or cannot safely have their dosage changed without a doctors approval, splitting pills should never be done solely on the advice of some book.

I have this med I take 25mg of nightly. Now, in normal doses of 200mg and more it's an antipsychotic. In my dose, it's for chronic insomnia.
25mg x 30tabs = $55
100mg x 30tabs = $80
200mg x 30tabs = $100

200 / 8 = 25mg. You can see the idea I had. Now, I lose maybe 25mg to dust when I cut a pill down that small, but I'm still getting each pill for much, much less than I would otherwise. Of course, this med is just fine if you need an INEXACT dose. I'm fine if I take 35mg one day and 15 the next. If you're taking an antidepressant, an antibiotic or an anti-antipathy medication, or anything else that requires preciseitude, don't do this or split down to 50% at most. You can get a good pillcutter at any pharmacy for 10 bucks.

Remember, some meds are marked XR (extended release) or for some other reason can't be cut. These meds need their coating to be intact to work properly - usually they slowly release the med in your intestines over a longer period. Do NOT cut these. If your med has a groove down the middle to make splitting it easier, cut to your hearts content. Otherwise, ask your pharmacist.

This alone saves me ton every month.

@hillsrovey: Believe it or not, many people are on drugs that have no positive benefit to them. A few studies have shown that 50-60% of people on allergy meds actually have no allergies.

@Cerb: You might have that mindset, but I can assure you that not every MD/DO in the field thinks the same. In medical clinics and hospitals I have worked in as well as Drs I've seen, physicians tend to prescribe the latest & greatest drugs while forgetting about their cheaper, older, and proven drugs which are now in generic form.

You say they're stopping the free lunches? I've not seen any slowdown of them. I did an experiment last year where I tried to see if I could eat a free lunch every single workday. I let the receptionist know my intentions (as well as brought her back plates) and I went a whole month without a problem. On many days I even had a choice of drug rep/caterers to choose from.

@PharmFatale: Absolutely awesome suggestion. Pharmacists spent a lot of time in school only to end up counting pills in most pharmacies. They're a very valuable and underutilized resource in the US.

Also, people should take a look at the warehouse clubs (Costco, etc.). No membership needed to use the pharmacies there and you'd be shocked at how much less their prices are. I transferred my parents' and grandmother's medications to Costco and in many cases Costco's price was actually less than what the insurance copay was at CVS.

@SkokieGuy: A lot of "natural remedies" are untrustworthy. Thanks to a scare campaign by the natural supplements industry, they are NOT overseen by the FDA the way that drug companies are. (Think about how scary that is...not even FDA levels of oversight.) There is no way to guarantee the strength or efficacy of certain products; you're relying on the goodwill of the manufacturer as to the strength and purity of the supplement.

I do agree with you that we need to research options outside of Big Pharma. It's just that, partly because I live in California, I know an awful lot of people who think if it comes from a plant, it's harmless and not a drug. Also that what's on the label is informative and true.

I take 30mg of a particular drug. A 30-day supply of the 10mg and 20mg dosage is part of Walmart's $4.00 generics. The 30mg is not.

I do not have insurance so I was paying ~$60 dollars a month for the 30mg dosage.

When I found out about this I asked my doctor to write me a perscription for 10mg and 20mg. She happily obliged and now I pay only $8 a month for my prescription, saving $52 dollars in the process. :)

I hold my physician in high regard, and hope she has bettr things to do with her time than I do, like comment on consumerist. I hope my doctor is healing people and whatnot.

The number of doctors that push expensive prescriptions and think all supplements are BS snake oil is very frustrating.

We have both had very good success moving some of our prescriptions over to a supplement instead for certain conditions. We both were getting some awful side effects from a couple of prescriptions. What was the pcp doc's solution? Take more drugs to cover the side effects. We switched to supplements, lost the side effects and are doing better than on the prescriptions. I just wish more doctors would be open minded to this in some situations.

I also switched some of my meds to over the counter options that work as well or better.

@MerylBurbank: Your doctor probably does not just go hang in the closet like a bat when she's not treating patients.

PLAY IT SMART!
12. Cut costs by splitting tablets

Not so smart for time-released Rx, like anti-depressants.

@MerylBurbank: What, like, fighting crime or something?

Most pharmaceutical companies have RX Assistance Programs for their medications. Check out the websites below. I think all of them have income guidelines but if you're low-income or without insurance they can be a big help. Usually you have to be referred by a social worker or advocate at your hospital or Dr.'s office, but you can get lots of name brand RX's for low or no cost.

[Social Worker]

www.rxassist.org
www.needymeds.com

@PharmFatale: I've had more useful advice from my pharmacist than most of my Drs.
Plus, my neighbors own a Pharmacy, so free home delivery!

If you're going to talk to a doctor about natural ways to wean yourself off of meds, a doctor of osteopathic medicine would be more appropriate (talk to a D.O. instead of an M.D.) This kind of concept aligns perfectly with their training.

Shop smart. Shop Walmart.

@thelushie:
"@Cerb: Most doctors want patients to eat well and exercise but the ones I have been to (and my mother has been to) don't want patients taking fish oil to lower cholestoral or any other type of natural remedy."
A lot of comments on drs not reccomending fish oil. That's probably because for a good deal of the pts we see, the lipid profiles are so unbelievable that fish oil would do very little by itself. Fish oil has been showed to reduce LDL, but no where near as well as statins like lipitor.

@SkokieGuy:
@Cerb: My rx for a pt complaining of sleep problems would depend on the circumstances. Sleep aids are not rec. for long term use. I would suggest they cut down their caffeine intake first and then we could try other things. I can't get too preachy here, I have had insomnia since I was a child and often have to take ambien.

As for supplements, a good deal of them are complete garbage. I will not rec. something based on folklore or because your herbalist/Navaho Spirit guide/etc says it cures ______. I will rec. it if there have been studies showing that it works (we frequently give pts chondroiten/Calcium supplements/etc). Aside from the lack of clinical trials regarding supplements, the fact that they are unregulated means there is a good chance the bioavailability of the supplement you are taking is close to zero.

@FLConsumer:
Well, I think a lot of those in private practice often fall into the "oooh new shiney drug" trap and prescribe the new drug (and a lot of times these drugs really are superior). Of course, there are many pts that demand the drug they just saw a commercial for. It comes down to good sense, which some doctors, for all their years of training, lack.

As for drug lunches being banned, they have been banned in many academic institutions around the country (which frankly I find insulting, I ahve never seen a drug rep present a new drug that didn't cause a lot of eye rolling). Private practice, which are generally the people rx'ing the $$ drugs, can of course continue to have drug lunches if they please

@Gann:
"If you're going to talk to a doctor about natural ways to wean yourself off of meds, a doctor of osteopathic medicine would be more appropriate (talk to a D.O. instead of an M.D.) This kind of concept aligns perfectly with their training. "

Sorry, but most DO's go into osteopathy because they can't get into an MD program and then ignore osteopathy as soon as they go into practice. This isn't meant to disparage DOs, whome I think are generally fine doctors, but to dispel the notion that they really are any different than MDs in regards to practice.
I have a good number of DO friends and they all tell me the same thing, Osteopathic manipulation is a load of horse poo in most cases.

@SkokieGuy: With the consolidation of media, it is impossible to get accurate health news and alternative medicine often does not result in a patentable treatment (asthma? drink more water) - so little research into non-drug therapies is performed.

Here's the problem with that theory: most of the "natural therapies" and "supplements" on the market are made and sold by exactly the same large, multinational pharmaceutical companies that bring you such classics as Vioxx and Olestra. Little research into those non-drug therapies is performed because a) it's cheaper, b) nobody's going to make them, and b) if the product is actually killing people, the pharma companies DON'T WANT TO KNOW.

#13 seems a bit iffy. Treating the pain from chemotherapy drugs with morphine would be a good example of how sometimes it is necessary to treat side effects with other meds.

@Cerb: I have recently made a significant lifestyle change as I hurtle towards yet another middle-aged birthday. It took a total commitment to exercise and healthy diet. The good news? I'm now looking forward to tapering off/quitting my very, very expensive blood pressure medication that my (now non-existent) health insurance didn't cover.

As a former health care worker, I remember all-too-well the patients letting the diet/exercise advice my boss would spend countless hours dispensing go in one ear and out the other - and how frustrated he would become over this.

@Gann: Yes, DOs are great! They see the body as a holistic system and not just a bunch of seperate organs to be brought into balance by whichever drub rep brought in the best donuts.

@Cerb: Hmmm, the ones I have seen are absolutely brillant and what is this about manipulation? That is a chiropractor (which, imo, is BS). I also find it funny that this comment is coming out of a supposed MD. Competition sucks in this day and age. Can't get into med school? Yeah right. Alot don't even try buy could have if the mood struck them. If I were to become a medical professional, I would take the DO route. I just can't be the type of person that is required to be an MD.

And before you say I just don't know as many of them. Yes I do. I socialize with the same type of people you do. I remember one doctor telling me about a med student who would kill small animals for fun. Short leap from small animals and people, isn't there? Most of the ones I know moan about only making $300,000 a year when Dr. Joe Shmoe makes $500,000.

And about the fish oil thing. It worked for me. I went off the statin and while the doctor (MD mind you) was lauding the benefits of the statin, I told him that it was making me a little ill and I went on fish oil. You should have seen the look on his face. Hilarious.

What a completely useless article. Wanna save money on drugs, don't buy em! Was this article written by captian obvious?

I can't wait for top twenty secret ways to prevent STDs!

As a physician, this list is very disturbing and potentially dangerous. 6, 7, 11 and 12 in particular can cause more harm than good.

Maybe I am a bit biased because I had two prescription drugs damn near kill me (vioxx & daypro) and neither were treating anything life threatening. I recently stopped taking two prescriptions that were making me so ill it was a struggle to function. I happened to go look them up and found out they had me on 4x the suggested max dose. I quit taking them and replaced with some OTC and a supplement. They were allergy drugs.

There are lots of snake oil salesmen and hippie new age nonsense around taking supplements but there are also some fairly straightforward companies and actual testing being done at universities and other credible sources. The problem is that the minute someone mentions supplements some people jump to the conclusion that it is snake oil or they were given or found bad information.

A good example (other than fish oil) is Bromelain. The FDA equivalent in Germany approved it for use as an anti-inflammatory. [www.umm.edu]

@thelushie: drub=drug

Oh and I forgot about the doctor who my mom was seeing when her regular one went off somewhere for a year. My mom was having major gastric problems (including eggy burps and such). Well, she was asking about the surgeon who was going to do the colonoscopy. The doctor made the comment "You might as well set up as his patient. Whatever it is will have to come out surgically." Turns out her OB/GYN tested her for h.pylori (sp?) and she tested positive. After a shitload of medication, all the problems cleared up. Problem solved. When she told her regular doctor about this (who did come back from the great abyss), she chalked it up to a personality difference. Not a doctor making a stupid and irrational statement. Begs the question, though, how do you remove a bacteria surgically. It scares me what would have happened if she had not seen her Ob/GYN.

Seems like most of these are obvious, though I think there is certain truth to the "change your lifestyle" one. So many are "sick" because of their own doing because of abuse or other poor choices, making you unhealthy to begin with, opening many doors of sickness.

No doctor forces you to do anything. If you do not want to take a medication, don't take it. Doctors have to prescribe, or else face the trial lawyers and jury who do not know any medicine, just give huge awards. As for medicine from China and India, do you think that the medications made in the USA, are actually made in the USA? They are made elsewhere and tabletized and bottled here, for 1000% profit.

I've found that going mail-order for my oral contraceptive cut a huge expense from my budget. I pay 15 dollars for a 3 month supply of Yaz. Basically I pay the same amount as someone who has a 5 dollar generic and goes to the pharmacy every month.

Yeah I know these prices are drastically less than what most of my friends pay for oral contraceptives, but I get great benefits through my mother who is a teacher.

@FLConsumer: Allergy meds also work for people with a bad cold or respiratory infection.

@SkokieGuy: I can only speak from my personal experience, but a year and a half ago I went to my doctor because I'd had some chest pains (and ended up in the ER) that the attending physician attributed to stress and anxiety. My doctor suggested both some lifestyle adjustments and an antianxiety SSRI. As hoped, the changes in lifestyle allowed me to drop my dose of the SSRI very soon, and I went from 10mg once a day to 5mg twice a week in a few months.

In this case, I think his approach was exactly the right one--make changes to the underlying problem, but use the tools available to help kickstart recovery.

(And, BTW, when I went from a 10mg dose to 5mg, I just got a pill splitter; the 10mg is only about 10% more than the 5mg.)

Seriously, Generic Drugs = Same Thing. Just because it doesn't say "Bayer" on the bottle doesn't mean it isn't. In fact after the patent has run out on drugs it's a Pharma-Industry standard for Generic companies to buy up rights to produce the drug and then Walgreens, Walmart, Target, etc all ask the generic companies to throw their labels on the bottles, cartons, etc.

Open a carton of Sinus PE liquid gels from Walmart and another from Walgreens and look at the strips...They're made by the same company :P. Some drugs aren't yet OTC or Generic yet, but eventually it all happens. Omeprazole(Prilsec) is a helluva lot cheaper if you buy it OTC from your pharmacy than to get it prescribed or to buy the Prilosec 'brand'.

"4. Eliminate medicines that were never needed"

Makers of ADD meds are going to be soooooo screwed.

@Paintbait: Fine for some things but not for all.

Take thyroid meds for example. There's a reason why you need to stick with the name brand sometimes.

@sir_eccles: Micro-doses are different. The thyroid thing gets brought up every time generics are. That is a case where generic is very different for some people.