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Strategies for reducing prescription costs.

Much like all components of the cost of living, the US national drug bill has increased, although more slowly than the rest of the national health care bill—drugs in 1970 made up $8.5 billion or 12.9% of the $65.8 billion consumed by the health sector1; in 1976 the drug bill was $11.1 billion or 8% of a total of $139.3 billion.2 A higher proportion of the cost of outpatient care is drug related; in the internal medicine clinic at our institution, 54% of the cost of a visit is for prescriptions. The corresponding figure for pediatric clinic is 21% (W. B. Applegate, M. B. Bennett, L. A. Chilton, et al, unpublished data, 1980). Inasmuch as many third-party payers do not cover outpatient prescription costs, savings in this area often go directly to the patient.
 The savings on the cost of prescription drugs can be effected through judicious prescribing for some patients. There are three categories of available methods to help patients save on prescriptions: one sure (taking advantage of "quantity discounts"), one controversial (generic prescribing), and one difficult (prescribing nothing when nothing is needed).
 In order to determine cost benefits that might accrue to the patient from generic prescribing and from seeking a quantity discount, I have surveyed Albuquerque pharmacies to determine their pricing procedures and their practices when they are given prescriptions written with the generic names of ten drugs.
 METHODS
 A questionnaire (available from the author upon request) was distributed to all pharmacies in the northwest and northeast quadrants of Albuquerque.