Recently, a lady was waiting in line at a pharmacy while the person in front of me picked up her prescription. Matter-of-factly, the pharmacist stated, "That'll be $850." Her only response was, "Really?" Telling the pharmacist she would have to call her doctor about a less expensive option, she left without her prescription.

Many of us regularly get sticker shock when we see how much drugs cost. More and more dramatic examples imply that there is no end to it. Let's discuss how to reduce our spending on prescription drugs, how we got to the point where some medications cost a million dollars or more per dose, and what needs to be changed in our exorbitant medication-industrial complex.

7 strategies to cut back on prescription medication costs
Take a look at these seven tactics to cut prescription costs. Savings will differ based on cost-sharing, deductibles, insurance, and donut holes.

Three questions to pose to your healthcare provider are: Are all of the medications you take really necessary? Can you safely cut back on the dosage of any medications you take? Could a generic or less expensive medication be used instead?

Check your health insurance plan's preferred medication list, or formulary, as these typically have lower costs than other comparable medications.

Split pills: If each pill contains more than the recommended dosage and can be divided, in certain circumstances, the cost of a prescription will be lower. For instance, if you typically take a 25-mg pill, splitting a 50-mg pill in half could result in lower copays and medication expenses. If the math doesn't add up for you, ask your pharmacist.

Find out if copays would be lower with a 90-day supply as opposed to a 30-day supply.

Look for prescription drug discount plans that provide savings. There are limitations and regional variations in availability. It's not always less expensive to use discount programs because payments made through them might not be deducted from your maximum out-of-pocket expenses or insurance deductible.
Evaluate your options with a pharmacist and compare costs at several pharmacies. There are instances when not using your insurance results in a lower cost.

Think about ordering online from a mail-order company (like Blink Health or Cost Plus Drug Company). Spending made via these websites, though, might not be deducted from your insurance deductible. Furthermore, online prices aren't always cheaper.

These steps can be time-consuming and beneficial to some people more than others. The unfortunate reality is that your wallet may not be significantly affected, even if you try your hardest.

Q. I manage my high blood pressure with hydrochlorothiazide (a diuretic) and long-acting metoprolol (a beta-blocker). I feel fine, but my heart rate doesn’t go up like it used to before I started taking the metoprolol. Does that mean I am not getting as much health benefit whenever I exercise?

A. All beta-blockers slow down your heart rate. The slower rate happens at rest and also when you exercise. To get the most from aerobic exercise, you would normally want your heart rate in a moderate-intensity zone for at least 30 minutes most days of the week. Moderate intensity means exercising at a heart rate that is 60% to 75% of your maximum.

An easy formula to find your maximum heart rate is 220 minus your age. So, if you are 60, your maximum heart rate is 160. Therefore, moderate-intensity exercise measured by your pulse is 96 to 120 beats per minute. While this formula usually works well to help gauge the aerobic intensity of exercise, it doesn’t work for people who take a beta-blocker. And unfortunately, there is no simple way to adjust for the slower rate of the drug.

Instead, you can use your breathing to gauge your effort. With moderate-intensity exercise, you should be able to talk, but with pauses to catch your breath. If you are breathing very hard and unable to speak during exercise, you are at high intensity.

Can beta-blockers affect your ability to work out? Studies that have addressed your question have not provided a definitive answer. A competitive athlete’s performance likely could be diminished by taking a beta-blocker. However, for most of us who exercise to stay healthy, the evidence tilts toward no decrease in benefit, even though you may not hit the standard heart rate goals.
No content on this site, regardless of date, should be used to replace direct medical advice from your doctor or another trained practitioner.
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