The following may not be news to some, but it was to me:

1. I just discovered that one can use the Costco pharmacy (in both USA and Canada) without having to be a Costco member.
Apparently Costco's Rx drug prices are at the low end of the spectrum compared with many other chain pharmacies.
Of course, in Canada pharmacies follow their provinces' drug formularies vis-à-vis pricing, with any price differentials being due to dispensing fee and ancillary services offered.

2. In the USA there is also available an app called Blink from Blink Health which can determine the best pricing on Rx drugs. Apparently ca 70,000 pharmacies will honor such pricing.

3. Also in the USA one might do better to buy Rx drugs with cash rather than going through one's insurance, the co-pays on which can be exorbitant.

I use GoodRx in NYC, but they seem to have nationwide coverage. (There's a login option, but membership isn't required, and I've got no idea what, if any, additional benefits it brings.)

They track your purchases, of course, but I've read that you can opt out.

Here's a comparison of GoodRx's and Blink's prices on my eye drops:

Prednisolone Acetate Prices - GoodRx

Prednisolone acetate – $49.43 Discount Price - Blink Health

GoodRx says that their prices may be cheaper than those of some insurances.

Their price on my skin cream is similarly low!

I don't know about the U.S. but, in Canada, they are obliged by law. Anyone with a licence to dispense drugs cannot turn away any person with a doctor's prescription.

I have found that pharmacists will adjust their prices downward when pressured. When my health plan only partially refunded a purchase, I asked and was told that the pharmacy was charging too much per pill.

I went to the pharmacy (a national chain) with the information and advised, "You either charge X per pill or I go to another pharmacy." They dropped the price.

If you need a drug that now has a generic equivalent, you should consider this company. They pay your pharmacist a subsidy that brings the cost of the real drug down to the cost of the generic, or even lower.

I checked one of my medications on Blink and it cost $108.50. On GoodRx the cost was $48.77. I think I'll stick with GoodRx.

I was just advised that:

4. Sam's Club Pharmacy (not in Canada) is also available to non-members.

It's also worth noting (as others have intimated) that showing Blink's (or other pharmacies' lower Rx cost) may persuade your pharmacy to match the price.

Maybe check all your meds' pricing.

I prefer to buy from an independent pharmacy (I've lost count, but I think there are 17 plus Walgreens and Rite Aid within 1/2 mile of my home.), but when I tell the pharmacists how much Walgreens charges me with my GoodRx coupons they just shake their heads and tell me to go there.

I don't know how they do it, but GoodRx's prices are simply waaay to low for others to match.

Edit: The independents will match Walgreens regular prices, but not the GoodRx prices.

Counting my two meds, GodRx is three for three, and by significant margins in all three instances.

I haven't got any others to check, so it'll be up to somebody else to find an instance in which they fail to deliver.

With the Medicare Advantage plan that both my wife and I have, the copays do vary somewhat, but we get the lowest ones by using Safeway. And, the one we use is less than 3 miles from where we live. The nearest Costco is further away.

I've never gone for Medicare Part D; the last time I looked, the lowest annual premium I could find was $310, and my annual Rxpenditure with GoodRx is about $20.

The Medicare Advantage Plan my wife and I each have includes parts C and D, and the premium each month is $0. Of course, to qualify for such plans, one needs to have "basic" Medicare Parts A & B.

From the feedback I've been getting via this forum and beyond it seems clear that, especially with respect to the situation in the USA, much depends on:
• where you're located
• how many and what sorts of pharmaceutical outlets are available (including legitimate/reliable online outlets)
• what types of insurance plan are in place

In Canada the variability is far less obvious. And down the pike, if and when the healthcare system gets its act together, pan-provincial/-territorial group buying may even the playing field even more and make Rx drugs much less expensive.

Spot on Grelber! It gets even more convoluted if you are taking off-formulary or high value medications that are only available through specialty pharmacies. There is a growing number of medications the low cost and mass market outlets such as Costco, Walgreens, CVS, etc. refuse to carry because the inventory and special handling cost is simply not worth the risk.

Before anyone complains about the cost being the result of drug company profiteering, that is often not the case. Rather these are medications that cannot be "manufactured" per se because they are living proteins that must be hand cultured on an almost dose for dose basis. But these medications are by far the most, if not only, effective treatments for painfully crippling diseases such as Rheumatoid Arthritis, Psoriasis, Psoriatic Arthritis, and a number of other auto-immune conditions. Ask me how I know and I will show you my pharmacy bills.

Most medical insurance handlers will charge the maximum that the insurance company is willing to pay, because they CAN. This doesn't affect your copay or deductible usually so most people don't care.

When I was between jobs I had to have a wisdom tooth removed. I'd been there before for several others and had been covered by insurance then, but not this time. When it came time to pay, I got the bill at the desk and then let them know I'd have to be paying for it myself since I didn't have insurance anymore. They more than cut the bill in half. They basically have a "insured" and an "uninsured" rate.

From one point of view you could consider this a bit of "socialism on the sly", as the insurers are somewhat indirectly helping me - they can charge the insured a little more, and charge me a little less

Almost correct, at least in the US. For the Medicare Advantage Plan my wife and I had last year, going to a "preferred" pharmacy would result in a lower co-pay (fortunately, we have no deductible for any of our benefits, including our current plan). For that plan, the closest preferred pharmacy was Safeway.

One other thing is that while we do not have a deductible for drugs, there are "Coverage Stages" with associated maximum tiers. For the "Initial Coverage Stage", that amount is $3,310 for each of us (there is also such stages for our medical benefits, but again, neither of us gets nowhere close to that amount). Fortunately, both my wife and I do not take many medications, and almost all the ones we take are generic equivalents, and thus we never come close to that amount (for each of us). My wife does take a brand name drug for her diabetes, but again, we are fortunate that our doctor gives us so many samples of it that we do not need to spend anything at all on that one.

1. a substantial part of medical cost is incurred by the highly trained clerical support staff necessary to process all of the government and insurance company paperwork.
2. Providers often incur long delays in receiving compensation from third party payers and therefore end up with substantial interest charges from their bankers.
3. There is a definite risk that in the end the healthcare provider will be unable to collect part or all of their costs. Insurance companies and Medicare can and do change their mind about whether a given procedure is covered or at what rate even if the procedure was pre-approved, patients walk-away from their deductible, etc

THE POINT IS: If a patient pays their bill in cash the health care provider avoids those costs and risk, so they can legitimately offer, if not a special rate per. se., a discount for cash. It is just good business.

I suspect the discount will not be that "great". Along similar lines, dental insurance for retirees, in the US, s**ks big time! So, when we go to the dentist and pay cash (actually use our credit card to build up reward points), the discount is only 10%.

Or, in the case of the U.S., it may be at this address.

As pointed out by V1 the cash discount can approach 50% for medical procedures. Dental economics are vastly different from medical for a number of reasons, not least of which is because with the exception of dental surgery, which is covered under medical not dental insurance, the contribution of third party payers (insurance) is a relatively small portion of the practice's income.

For folks that have Medicare Parts A & B (like my wife and I), there are a number of Medicare supplement plans that we can choose from during Open Enrollment, which occurs from October through December. THe 3 types of plans we can choose from are:

Plan C - better coverage for Medical "procedures".

Plan D - Prescription Drug Coverage

Plan C & D - Combines the benefits of Plans C and D above.

My wife and I have always had Plan C & D (called a Medicare Advantage Plan).

Of course, each plan that we can choose from has different "features", and one should choose a plan that fits their needs. For my wife and I, given that we are in very good health, and have no major issues, we always choose an "HMO TYpe"plan, with no monthly premium. And, as I mentioned above, we can change our plan during the Open Enrollment period for the following year. We have done that each time, and it has worked out well.

For prescriptions, in just about all cases (except when a preferred pharmacy can be used, or one uses mail order), the copays for drugs are the same.

You don't understand. InnoviCares is not a drug plan and does not have any interaction with your drug plan. If only interacts with your pharmacist at the time you are filling a prescription. It is simply a way to ensure you get the original drug, not the generic.

It works like this:

1. Your pharmacist has both the real drug and the generic available.

2. For "Drug X" 100 pills cost 200.00 but 100 generic pills cost only 60.00

3. Your health plan is only willing to pay the generic cost.

4. If you are registered with InnoviCares, you get the real drug even though It costs 200.00.

5. While you are filling your prescription, InnoviCares remits the difference to the pharmacist.

6. The pharmacist then charges you only for the cost of the generic.

7. You submit your claim for the cost of the generic, but you got the real drug.

I have been enrolled with InnoviCares for about four years and, as a person who remains leery of generics (no, I do not wish to have the debate), InnoviCares is the answer. There are no fees or costs of any kind to be a member.

The links provided both point to the Canadian scene (my error) but I have to assume there is an equivalent American program at InnoviCares. It's worth a search.

Well, it's not goodrx.com; their "break" on the generic equivalent of my drops is only $10 off the $137 price.

innoviCares doesn't seem to have a US presence.

There are actually more than three choices if you opt for a MediGap plan (these use letters F through N and are non-HMO). The coverages vary in co-pays, deductibles and what is covered. Under the Affordable Care Act each plan must be the same across all providers. That is, any insurance company's Plan N will cover exactly the same things with the same co-pays, etc. as any other company's Plan N. The only difference will be the monthly premium charged and the level of service provided.

None of these Plans F-N include drug coverage, which is where buying a Plan D would come in. Plan D's can have varying levels of co-pays and deductibles, based on the provider.

What is available to any individual will definitely vary by geography.

Interestingly, when looking at out-of-pocket costs for drugs under different plans, the insurance company will use the retail price of the drug even if you paid less. Just one more way of moving the consumer faster into the Medicare Drug Plan "doughnut hole" (where the individual must cover full costs for a period).

FYI: www.innovicares.ca [via Firefox]
This Connection is Untrusted
www.innovicares.ca uses an invalid security certificate.
The certificate is not trusted because the issuer certificate is unknown.
The server might not be sending the appropriate intermediate certificates.
An additional root certificate may need to be imported.
(Error code: sec_error_unknown_issuer)

innoviCares | Sampling Technologies Limited
smartsti.com/innovicares/
This page passes muster, but points to the above, which continues to be flagged as "untrusted".

Subsequent attempts to contact sti Technologies via their toll-free number (1-877-790-1991) led to being placed on hold and then disconnected after 100-120 seconds (no matter which option for assistance was chosen).

All does not seem to be right in Whoville.

Hmmmmm. Perhaps it's actually: All does not seem to be right in FireFoxville.

I use Safari and this link takes me directly to their Canadian website (sans certificate cautions) where I can also find their Canadian physical address and toll-free phone number. I've never had occasion to phone them so can't comment on your experience.

However, I can comment on their service - just last week they provided $230.00 toward the cost of my prescription.

That's too bad.....and surprising, as I would have thought the American market is more important than the Canadian in just about anything.

I went to a PC with IE browser and got into innoviCares site without being cautioned off.
When I checked on what's covered, they were all "high end" and definitely "directed" pharmaceuticals, none of which were relevant to me — which isn't to say that they might not be down the road.

I can certainly see why the manufacturers might subsidize their products vis-à-vis generics. But even more fascinating is that they're willing to do so by matching the generic pricing (via innoviCares). Most curious.

It may have something to do with Canadian Rx prices being much cheaper than US prices to begin with.

The disparity between the prices of generic and non-generic drugs in the U.S. may simply be too big to be absorbed by any organization regardless of its revenue sources.

Yet another surprise...... We're used to the idea that everything is cheaper in the U.S..

I'm surprised that you're surprised.

Canada has been a source of inexpensive drugs for Americans for years. (cheap canadian drugs for americans - Google Search)

Ah yes, now I remember. Blame it on a synaptic short circuit....I wonder if there's a drug for that.

If you can still say "synaptic short circuit" you don't need one!

Our drug plan does not "lock us out" regarding non-generic drugs, and for a good portion of them, the co-pay is not that bad. So, a company like Inn0viCares is useless to us, especially since it is only available in Canada.

Yeah, I am "somewhat" aware of those, but as I stated above, one should choose a plan that suits their needs. An HMO type Medicare Advantage Plan (Parts C & D), with no premium payment, inexpensive co-pays for doctor/specialist visits, and low co-pays for drugs is perfect for us.

I am also familiar with the "doughnut hole", and fortunately we have never got close to it.