Cutting prescription prices down to size A BIG DEAL

April 25, 1995|By Patricia Meisol | Patricia Meisol,Sun Staff Writer

Every time Estele Zemil needs a new prescription drug, she calls around to pharmacies at Giant, Rite-Aid and other stores to find the cheapest price. "I was never that way before," says the 79-year-old former teacher, "but we didn't use so many drugs."

Mrs. Zemil says she often discovers bargains for Lopressor and other drugs she takes for high blood pressure. But the Baltimore woman doesn't have to drive all over town to take advantage of them. Instead she convinces her regular druggist to match the lower price.

It's a game savvy shoppers like Mrs. Zemil are playing to great advantage in the highly competitive prescription drug market.

Almost daily, consumers are bombarded with valuable coupons or discounts in mailers, newspaper ads or stores, leaving them with a dazzling and sometimes confusing array of choices when it comes to purchasing prescription drugs.

In the past six months, a growing number of pharmacies have lowered prices. Many stores, including Giant and Rite-Aid, honor competitors' coupons. And they'll match competitors' prices if challenged.

Store to store, prices for the same drug can differ dramatically. In a spot check for prices of six widely used drugs at area stores, The Sun found differences ranging from a few cents to $36.

Nobody knows how better to shop for prescription drugs than senior citizens like Mrs. Zemil, whose health insurance doesn't extend to prescriptions. She and her husband, Sidney, also 79, spend at least $50 for each of the five types of drugs they take daily.

About 30 percent of the general population -- seniors, young people, the poor -- must pay cash for the medicine they need. Among seniors, the number is closer to 60 percent. The numbers are expected to grow as employers cut back on drug coverage to trim their health bills.

Cash-paying customers -- those without insurance -- often pay ,, the highest prices these days, because pharmacies charge them extra to make up shortfalls from granting huge discounts to managed care companies or other insurers.

And prices vary greatly for drugs that some insurance companies don't pay for, such as birth-control pills, or drugs that insured patients pay for themselves for privacy reasons -- Zovirax, for instance, which is used to treat sexually transmitted diseases, or Prozac, a drug widely used for depression.

But many pharmacies are willing to wheel and deal when it comes to price. The reason is that pharmacists want to please existing customers, who tend to be loyal once they settle in. Additionally, pharmacists encourage people to keep all their prescriptions in one spot for medical reasons.

"All this running around isn't good for the customer or us," says Russ Fair, Giant vice president for pharmacy operations. As a result, Giant will meet competitors' prices and deduct another $1 when a lower price elsewhere is brought to its attention, he says.

In short, consumers don't have to visit store after store in search of the best price -- they only have to know enough to ask for it.

Indeed, when the price of one of her prescription drugs rose $8 last week, an 80-year-old widow in a retirement home in Northwest Baltimore saved $4 by working her telephone to find lower prices elsewhere and asking her pharmacist to meet them.

Comparison shopping for drug prices became a regular habit for this woman after her husband, a pharmacist himself, died in 1990, and she saw the spread between wholesale prices she had been paying and the retail market.

She is unfailingly polite, but firm, and almost always gets results. (For instance, she is not being named here after warning this reporter: "If you use my name, I will kill you. I don't have a gun, but I'll kill you somehow.")

This woman says that when it comes to buying prescription drugs, "I'm a regular investigator. You have to be."

One of the things that puzzles her, she says, is that even after taking into consideration the overhead at larger stores, their prices seem higher than those of competitors. "When you do business in volume, prices should be cheaper, but I haven't seen that," she says.

Many factors in price

Yes, sales volume can be irrelevant to price. More important factors may include whether the store is part of a chain with many locations, whether prescription drugs are its only business, and how popular the drug is in the area where the store is located.

One of the stores with the lowest prices in The Sun's survey proved to be Drug City in Dundalk, a 41-year-old independent pharmacy operated by a father-and-son team. The pair, Harry and Mark Lichtman, say they are able to take a markup as low as $3 on drugs because they are a one-store operation with low overhead and regular customers. The 15,000-square-foot store, a quirky place with its own postal service, free blood pressure machines, and walls and walls of gifts and collectibles, prides itself on filling prescriptions in 10 minutes.

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