WNCT9 prescription savings story

GREENVILLE N.C. (WNCT) – Pharmacy prices can differ from store to store and should be treated like buying a car.

Most people think of just going to the pharmacy closest to them instead of looking around for their medication.

When in reality, it can differ by sometimes a significant amount.

There are different ways that you can go about finding these prices.

Certain apps will bring up every pharmacy within a number of miles of your current location.

From there, you type in the medication that you’re looking for and all of the prices will come up right in front of you.

A creator of one of those apps says he looks for the cheapest prices for everything else – so why not do it for our medication.

“Any pharmacies have an in store savings program for low cost drugs,” said Shawn Ohri, creator of ScriptSave WellRx. “But it doesn’t mean all drugs are low cost at that pharmacy, they’re bringing in a good number of prescriptions at a low cost but there may be others that don’t have a low cost.”

You can find apps like this in the Apple Store or the Google Play Store.

Some are free and others require a subscription.

9 On Your Side looked up some of the top medications used in Greenville and found a difference of almost $30 in some of the different locations, showing it really does work to look before you shop.

Top 10 Drugs (non-controls)  Greenville, NC
Reporting Period: Jan 2017 – June 2017
Date Prepared: 07/27/2017
Rank Drug     Lowest Pharmacy
1 AMLODIPINE BESYLATE     Harris Teeter Pharmacy
2 Generic form of Norvasc (High blood pressure, chest pain)

ATORVASTATIN CALCIUM

    Hometown Discount Pharmacy of Greenville
3 Generic form of Lipitor (High Cholesterol)

HYDROCHLOROTHIAZIDE

    Harris Teeter Pharmacy
4 Waterpill/Diuretic (High blood pressure and fluid retention)

METOPROLOL SUCCINATE

    Rite Aid Pharmacy
5 Generic form of Toprol (High blood pressure, chest pain, and heart failure)

GABAPENTIN

    Rite Aid Pharmacy
6 Generic form of Neurontin (Nerve pain medication – very common)

METOPROLOL TARTRATE

    Walmart Pharmacy
7 Generic form of Lopressor (High blood pressure, chest pain, and heart failure)

LEVOTHYROXINE SODIUM

    Walmart Pharmacy
8 Generic form of Synthroid (Thyroid hormone)

SERTRALINE HCL

    Harris Teeter Pharmacy
9 Generic form of Zoloft (Anxiety/Deperession)

LISINOPRIL

    Harris Teeter Pharmacy
10 Very common heart failure / high blood pressure medication.

PREDNISONE  Steroid used for inflammation.

    Walmart Pharmacy
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prescription savings pill-splitting - wellrx

by Hayde Blanco, PharmD Candidate
University of Arizona College of Pharmacy

Pill splitting refers to breaking a pill down to obtain a smaller amount of the whole pill. Your doctor can write a prescription that is usually double the dosage of what you should take in one day. You can then cut the pill in half, making the smaller dose that should actually be taken. For instance, a medication might be prescribed for 40 mg, but then the pill is split so you actually end up taking 20 mg.

Why Split Pills?

Pill splitting can be a huge help in cost savings if the same amount of the larger and smaller doses are sold at a similar price. Some of the most common reasons for pill splitting are:

  • Reduce the costs associated with a medication
  • Take a dosage of a drug that is not already available.

These methods can be useful to help some people save on their prescription medications, but are not suitable for everyone or for every type of pill. There are some risk factors that should be taken into consideration before splitting any pills.

Pill Splitting Concerns

When a pill is split, there may be different amounts in each half of the pill. Since the active ingredient in each pill is not usually evenly distributed throughout the pill, this may lead to one half containing more of the active ingredient than the other, giving it more potency. Some pills may be hard to split due to having an unusual shape, being too hard, or crumbling easily. There are also some medications that should never be split.

Pharmaceutical companies create some pills that are scored, meaning that they have a line down the middle to make it easier to split.

pill splitting sertaline
This pill is generic sertraline 100mg (an antidepressant) with a line down the middle. Generic pricing for 30 tablets of 100mg averages about $11.50. Generic pricing for 30 tablets of 50mg averages about $10.00. By cutting the 100mg dose in half, you would save close to half of the cost.

Some of the risk of pill splitting is related to the individual, instead of being related to the pill. A common issue is forgetting to split a pill, which could lead to taking double the amount of the prescribed dose. The directions might also be unclear if the bottle says to take one daily, but your doctor says to take one-half daily. You should always verify with your doctor if you are not sure about the prescription dosage you should be taking.

​Although there are risks involved with pill spitting, it can be an appropriate cost saving technique for some people. If pills are being split, there are some recommendations that should be followed to reduce the risks.

What are the Risks?

Some of the risk can be related to the individual instead of being related to the pill. A common issue is forgetting to split a pill, which could lead to taking twice or more of the needed dose. The directions might also be unclear if the bottle says to take one daily, but your doctor says to take one-half daily. Always verify with your doctor if you are not sure how much you should be taking.

​Although there are risks involved with pill spitting it can be an appropriate cost saving technique for some people. If pills are being split, there are some recommendations that should be followed to reduce the risks.

Splitting Pills Safely

  1. Always discuss your choices with a pharmacist or doctor before deciding to split a pill.
  2. Have a general understanding of which pills are appropriate to split and which are not.
  3. Use an appropriate pill cutter. Using a pill cutter instead of a knife or other object cuts the pill more evenly and leads to better distribution of the active ingredient.
  4. Cut the pills right before taking them instead of cutting them all at the same time. Since the distribution of the active ingredient is often not the same on both sides, taking both halves on consecutive days allows for a more even intake of the active ingredient. Additionally, a medication might not be as effective at treating your symptoms when it is broken down and exposed to air and moisture over time.
  5. Make sure you are can put this into practice safely or have someone help you if you can’t. If you have any problems with memory, trouble using your hands, or do not think you would be able to split the pills on an ongoing basis this will not be an appropriate technique to use.

These medications are usually appropriate to split, but always check with your pharmacist or doctor if it is okay to split your medication:

  • High blood pressure medications
  • High cholesterol medications (statins, like Lipitor, Crestor, or Zocor)
  • Depression medications.

These pills should not be split:

  • Capsules
  • Enteric-coated medications
  • Extended release or long acting medications
  • Combination pills containing more than one drug
  • Prepackaged pills, like birth control
  • Certain classes of medications, such as chemotherapy drugs
  • Pills with a small therapeutic index (these pills need to be taken at a very precise dose because they can lead to side effects more easily if more than the prescribed dose is taken or they might not be as effective if too little is taken).

Always remember to talk to your healthcare provider to be sure it’s appropriate for you to split a certain pill before using this cost saving technique. When done correctly, pill splitting can be a safe and effective method to reduce prescription medication costs.

 

References:

https://www.linkedin.com/pulse/tablet-splitting-risky-practice-stuart-silverman

http://www.consumerreports.org/drugs/is-it-safe-to-split-pills-in-half/

http://www.consumerreports.org/drugs/get-the-right-pill-splitter-and-save-money-on-your-medication/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827917/


For the best Rx price on statins and other medications,
visit www.WellRx.com.

Compare prices at more than
62,000 pharmacies nationwide.

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Role of vitamin d and statin induced muscle pain

by James Ketterer, PharmD

Statins are a class of drugs used to lower cholesterol and decrease the risk of cardiovascular events. They work by inhibiting an enzyme from completing an early step in the body’s process of synthesizing cholesterol. Statins are among the most commonly prescribed medications in the country. Approximately 1-2% of patients on statins report experiencing muscle pain. This pain can present itself in a variety of ways but most often results in flu-like aches and pains. The muscles may feel stiff or sore like the feeling after working out. This usually effects the larger muscles of the body such as parts of the back or thighs. This side effect is often responsible for patients discontinuing the use of these drugs.

Does Vitamin D Play a Role in Statin-induced Muscle Pain?

Do statins cause muscle pain? The exact cause of this phenomenon is not completely understood, but many researchers have hypothesized that vitamin D levels may play a role. Vitamin D is mainly produced in the skin from sun exposure. However, this source is not active. The liver and kidneys are responsible for activating the vitamin D which then plays a role in facilitating intestinal absorption of essential nutrients as well as balancing bone health homeostasis. Vitamin D deficiencies often present with similar muscle pain as those found as a side effect in statins.

Some researchers have theorized that statins could reduce vitamin D levels because certain types of cholesterol carry vitamin D and when the cholesterol is reduced, less vitamin D could be transported. On the other hand, many have theorized that since both vitamin D and statins are metabolized by the same enzyme in the liver, the use of statins could delay metabolism of vitamin D, thus increasing levels in the blood.

Muscle Pain in Clinical Trials

Clinical trials and various other studies and reports have yielded mixed results on muscle pain in statin users with low compared to high levels of vitamin D. A large analysis of these trials showed that more studies resulted in statin users having higher levels of vitamin D on average. One retrospective study divided statin users into 4 groups, 1 being the lowest vitamin D levels and 4 being the highest. Group 1 was 1.21 times more likely to develop muscle pain than group 4. Another study showed statin users with vitamin D levels of less than 15 ng/mL were 1.9 times more likely to experience muscle pain compared with non-statin users. The statin users with higher levels of vitamin D did not have higher risk for muscle pain compared with non-statin users.

When a patient experiences what is believed to be the side effect of a drug, they are often taken off of the drug to see if the symptoms resolve. If they do resolve, sometimes the patient is started back on the drug to see if the symptoms return. This a referred to as a “rechallenge”. One chart review showed that returning vitamin D levels to a sufficient level before a rechallenge in statin users who had experienced muscle pain, increased their tolerability to statins.

Do Vitamin D Supplements Help Reduce Statin-induced Muscle Pain?

Some studies have given vitamin D supplements to statin users experiencing muscle pain. While these studies were uncontrolled, they did show improvement in muscle pain in nearly 90% of patients.

These are just a few of the examples of research looking at the correlation between stain use and vitamin D levels as a possible cause of muscle pain. While nothing is definitive at this point, patients on statins that are experiencing muscle pain may want to explore vitamin D supplementation as a possible resolution plan. The benefits of statins are well documented in patients with heart risks. Any side effects should be attempted to be overcome before giving up on the statin and assuming it is the cause.

References:

Gregory, Philip J. ” Vitamin D and Statin-Related Myalgia”. Medscape. 2017. Web. 10 Mar. 2017.

Simvastatin.  Micromedex Solutions.  Truven Health Analytics, Inc. Ann Arbor, MI.  Available at: http://www.micromedexsolutions.com.  Accessed March 20, 2017.


For the best Rx price on statins,
visit www.WellRx.com.

Compare prices at more than
62,000 pharmacies nationwide.

 

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ScriptSave WellRx - Statins and Liver Damage

by: James Ketterer, PharmD Candidate
University of Arizona College of Pharmacy

If your doctor has said you have high cholesterol, it’s likely that you’ve heard or read about about the potential side effects of statin drugs and their impact on liver.

Doctors often prescribe statins for people with high cholesterol levels to lower their total cholesterol and reduce their risk of a heart attack or stroke. While statins are highly effective, they have been linked to muscle pain, digestive problems and mental fuzziness in some people and may rarely cause liver damage.

Cholesterol and triglycerides are lipids (fats) that are stored in the body and serve as a source of energy. Lipids, together with proteins and carbohydrates, are the main components of living cells. When lipid levels in the bloodstream are too high or low, this condition is called dyslipidemia. The most common types of dyslipidemia are:

  • High levels of low-density lipoprotein (LDL or “bad”) cholesterol
  • Low levels of high-density lipoprotein (HDL or “good”) cholesterol
  • High levels of triglycerides

You may have heard stories of people who have experienced devastating liver damage from their use of drugs like atorvastatin (Lipitor), rosuvastatin (Crestor) and simvastatin (Zocor). Less than 3% of patients on statins report muscle pain while less than 0.5% report rhabdomyolysis (A breakdown of muscle tissue that releases a damaging protein into the blood).

Recently, the risk of statin-induced liver injury has become a hot topic, since this class of drugs is metabolized by enzymes in the liver. Liver injury has a broad definition, but generally includes, at minimum, highly elevated liver enzymes which are directly correlated with liver function and often a precursor to various liver diseases.

Statin Studies

While studies on the safety of these drugs have included thousands of patients, it’s difficult to determine if something like liver injury is one of the side effects of statin drugs, or happening for some other reason. Drug-induced side effects are more commonly identified after a drug hits the market and patients and physicians begin reporting problem cases to the drug manufacturers.

There have been a few studies around the world that have looked at drug-induced liver injury. A study in Iceland identified 96 patients with drug-induced liver injury. Three of those 96 were due to statins (1 with simvastatin and 2 with atorvastatin). During the trial, over 27,000 people were treated with simvastatin and over 7,000 with atorvastatin. That means that 1 out of 27,000 people on simvastatin and 1 out of 3,500 people on atorvastatin had drug-induced liver injury in Iceland over that 2 year period. Of all statins, simvastatin and atorvastatin are responsible for most reported incidents of liver damage, but this is likely just due to the fact that they are prescribed the most.

The Spanish Hepatotoxicity Registry identified 858 cases of drug-induce liver injury. Of those cases they attributed 47 (5.5%) of them to statin use. The total number of patients on statins was not available.

One of the latest studies from the USA ran from 2004 to 2014, examining drug-induced liver injury identified 1188 cases. They determined that about 2% could be contributed to statin use.

A Swedish study compared the reported statin-induced liver injuries to the total number of statin users (based on sales) and found that 1.2 people experience liver injury due to statins per 100,000 users of statins.

A Rare Occurrence

Outside of these large studies, there have been case reports of patients experiencing liver injury following an increase in dosage of their statins. These are few and far between, and are corrected by decreasing or discontinuing the medication. Some of these patients have been restarted on statins and experienced the same liver problems, confirming the drug as the cause. People that experience statin induced liver injury have a generally positive prognosis. These injuries are usually short-term and reversible. One study of interest that looked at 298 patients whom had experienced drug-induced liver injury and found that only 7 of them had any signs of liver problems one year later.

While there’s a lot of information on the safety of statins in the media, the truth is that side effects of statin drugs, including livery injury, are very rare. That’s not to say that they don’t occur, but rather that the benefits in patients with cardiovascular risk, even those with underlying liver problems, substantially outweigh the potential risks.

 

References

Björnsson, Einar S. “Hepatotoxicity Of Statins And Other Lipid-Lowering Agents”. Medscape. N.p., 2017. Web. 9 Mar. 2017.

Simvastatin.  Micromedex Solutions.  Truven Health Analytics, Inc. Ann Arbor, MI.  Available at: http://www.micromedexsolutions.com.  Accessed March 2, 2017.

 

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visit www.WellRx.com.

Compare prices at more than
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Photo of large amounts of Tylenol for ScriptSave WellRx

Can You Take Too Much Tylenol?

There are many over the counter pain medications often taken to treat minor aches and pains. One of the most frequently purchased pain medicines is Tylenol, which is also known by its common generic name, acetaminophen. You may also see acetaminophen abbreviated as APAP on certain medication labels.

Not only is there acetaminophen in pain relievers, but there is also acetaminophen in many over the counter cold, flu and headache medications. Acetaminophen is often combined with prescription medication as well. This makes it easy for a person to unintentionally ingest too much acetaminophen. Because acetaminophen is sold over the counter, many people think this is a safe medicine and overdose is not possible, however when taken in large doses, acetaminophen can cause liver toxicity, and possibly even death. According to the U.S. National Library of Medicine, acetaminophen overdose is one of the most common poisonings that can happen to consumers worldwide.

How Much Tylenol Can You Take in One Day?

Be cautious of how much acetaminophen you take in one day. This includes any acetaminophen you take in prescription products as well as in any over the counter products. The maximum recommended dose of acetaminophen for an adult is 4,000mg per day. This sounds like a lot, but when combining products that contain acetaminophen, this dose can easily be ingested in one day. Try not to combine any products containing acetaminophen together. Common strengths of Tylenol or acetaminophen include:

Tylenol 325mg (adults should not take more than twelve 325mg tablets in one day)

Tylenol Extra Strength 500mg (adults should not take more than eight 500mg tablets in one day)

Tylenol Arthritis 650mg (adults should not take more than six 650mg tablets in one day)

Acetaminophen Toxicity

Signs and symptoms of acetaminophen toxicity may not occur until 12 or more hours after the medication has been ingested. Some signs and symptoms of acetaminophen toxicity include abdominal pain, nausea, vomiting, diarrhea, appetite loss and/or convulsions. It is important that you do not take more than the recommended dose of acetaminophen to avoid any damaging affects to your organs, especially your liver.

If you feel like you are not getting sufficient pain relief on the maximum doses of acetaminophen, speak to your doctor or pharmacist.

Reference:
http://livertox.nih.gov/Acetaminophen.htm
https://www.nlm.nih.gov/medlineplus/ency/article/002598.htm


How Much Tylenol is Too Much?

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