Lower your drug costs.(5-MINUTE CONSULT)

A 60-YEAR-OLD MAN who had been in good health went to the emergency room, complaining of nausea. He was diagnosed with high blood pressure, high cholesterol, and early diabetes. ER doctors were able to relieve his nausea at the hospital, but the man left with five prescriptions (four brand-name drugs and a generic) to treat his new ailments.

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The upbeat attitude he had about his health turned to shock when he went to fill the prescriptions at his local pharmacy: His total bill was $300 for the first month's supply. The patient, who lacked prescription-drug insurance, couldn't afford that, nor could he afford to see a different doctor. He was referred to me at a Veterans Affairs clinic in Oregon. After examining him, I focused on how he could receive the best care within his financial means.

Cost is rarely a favorite topic in a doctor's office. Some patients are shy about discussing medical costs, but I knew I had to talk with my patient about money. And given the current recession, he's probably not the only person in such tight circumstances.

Cutting back

I explained my three Rs for economizing on prescriptions. Here's what we did:

1. We removed one of the three blood-pressure drugs, a brand-name medication that had some side effects that the patient wasn't aware of. We decided to try the two others first and add back the third if needed.