WEB EXCLUSIVE: The real cost of your prescription and why shopping can save you money

Fill your prescription, or pay the bills?

It's the tough decision more are forced to make as prices for the most common prescriptions double.

Over the last year, prescription costs have shot up more than any other category of medical care.

News 13's investigative unit is cracking the prescription-drug shell game to show you what's behind the steep increases, and what you can do to get the lowest price.

"This is every morning," explains Denise Mauck of Asheville.

It's a routine Denise would gladly trade.

"Some of them you have to choke down. I've asked my doctors, do I absolutely need to have these, and based on the things that are wrong with me they say, well, unless you want to be dead," said Mauck.

"One of these pens will lasts me three and a half days," said Mauck.

The bill for the insulin she can't live without is the hardest part to swallow.

"My insulin went from $45 a month to $178 a month, and then $182 the next month," said Mauck.

Denise, like many, falls through a financial trapdoor. When her basic benefits max out, she's left paying 45 percent of the cost, and higher for generics. Rising prescription prices are forcing more into the gap.

With no price controls for prescriptions in the U.S., finding the "real" cost isn't easy.

"There are a lot of loopholes, and there's a lot of opportunity in the system right now for people to exploit those loopholes for profit," explained Brad Melson, pharmacist director at Blue Ridge Pharmacy.

Using Cymbalta, Nexium, and Crestor, News 13 investigated prices at a dozen pharmacies. In the same zip code, even among the same retail chain, we uncovered different prices.

Name-brand Crestor can swing from $325 to $231 -- a $94 difference. The difference between generic Cymbalta alternatives is $209.

"There's a number called an NDC number. It's very specific for drug products. They'll give you the generic they have on their shelf, and they're giving you accurate information. It just may not be the same generic that CVS has on their shelf," said Stephanie Kiser, director of rural health and wellness for the UNC Eshelman School of Pharmacy, which is part of the University of North Carolina at Chapel Hill.

Not one pharmacy would cough up an insurance price. Pharmacies often sign exclusive agreements with insurers, locking in rebates for volume.

"Whatever contract that we've assigned with them will automatically determine what would be paid so what the co-pay is, what the pharmacy is reimbursed. Aall of that is already set in stone," said Tasha Michaels, a pharmacist.

Large insurers including Blue Cross Blue Shield of North Carolina also wouldn't give up what they pay.

But News 13 did find insurers moving some drugs out of lower priced tiers, or dropping them altogether to force manufacturers to lower prices.

"By moving a drug product into a higher tier, it makes consumers think twice about 'Is this the medication i would choose to be on,' which makes them often go back to their provider and request a different agent," said Kiser.

Glaxco-Smith-Kline was the only manufacturer to respond to my request, claiming, they "aim to strike the right balance, maximizing patient access, acknowledging the value of our medicines."

So where are the best prices?

At discount retailers like Costco and local pharmacies, not chain drug stores. Good RX and One RX can help you compare prices online.

"You can actually put in the medication name. You can put in the specific ID number if you know what that is, and it will give you a list of pricing within a certain mileage distance," said Kiser.

Also, you can negotiate. Ask your doctor for a coupon. Some pharmacies have discount plans or will price-match and form a relationship with your pharmacist.

"Pharmacists go to school for six years, and then many of them go on and do residencies and fellowships," said Kiser. "They are your medication experts on your team.".

Pharmacists call for more transparency to expose how prices are set.

"We've got to find the level playing field, because patients cannot continue to take on the burden of the growth in pricing we're seeing, at the rate we're seeing it," said Kiser.

If you get a new prescription, always ask if there's a generic option.

Pharmacists say they're really the same product, just produced by a different manufacturer because the patent has been released.

Here are the price comparison our News 13 investigates team did with local pharmacies right here in Asheville.

You can see for yourself the big price differences, and what you can save if you price shop.

Pharmacies also told us you should always ask what the cash price might be to see if you can get a better deal just paying cash versus a set price your insurance provider may have negotiated for the drug with the pharmacy.

In some instances we found paying cash actually saved a customer money.

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