The eDrugSearch.com e-book “99 Ways to Save Money on Your Prescription Drugs, 2009 Edition” is now available on Scribd, where you can see a preview of the book’s first 10 pages before purchasing.

Check it out and start saving on your prescription drugs now!

As readers of this blog know, we sometimes grow weary of defending legitimate online pharmacies against those uninformed (and/or Big Pharma-funded) voices who enjoying tarring all online pharmacies with the same broad brush.

Yes, we know there is a big problem with rogue online pharmacies. That’s why we created eDrugSearch.com — to create a place you could come to buy medications from pharmacies that are all properly licensed by the Canadian government.

Did you know that, for all the hyperventilating about the safety of online pharmacies, there is not a single reported case of an American citizen receiving adulterated, impure or improper medications from a licensed Canadian pharmacy? It’s true — not one.

Wal-Mart’s track record isn’t as good.

You may recall that last year, a Wal-Mart pharmacist’s error sent a teenager into a coma.

And last week, we received some unexpected (in fact, downright bizarre) insight into how Wal-Mart cuts corners on the prices its pharmacies charge.

According to the Huffington Post:

ABC 4 News in Cedar City, Utah—a town of roughly 28,000 people—reported that a routine traffic stop of three men led to a bizarre tale of prescription narcotics, illegal couriers, a Las Vegas drug supplier, and the world’s largest retailer.

Diego Jimenez, Maricio Jimenez, and Kyle Gutierrez are being held in a jail in Iron County while local authorities sift through their odd story. Police pulled over their car as it was traveling north on Route 15 just south of 100 miles per hour. The men claim they were hired to deliver prescription drugs to at least three Wal-Mart stores, including the superstore on South Providence Drive in Cedar City, Utah, which has an in-store pharmacy. The three men reportedly had already been to the Wal-Mart supercenter in St. George, Utah, which is south of Cedar City on Route 15, and the Wal-Mart superstore on Route 15 further south in Mesquite, Nevada, on the border with Arizona.

While searching the car, police found marijuana paraphernalia, two boxes of prescription narcotics, and a retail invoice for $30,000. Two of the three men in the car admitted to being illegal aliens. The men claimed they had been retained by a company called Nevada Courier, given $150 and a tank of gas to “drive these medications down here and drop them off.”

The three suspects arrested are all reportedly from Las Vegas. The police verified their story by checking with the retailer. “I called Wal-Mart,” one police spokesman told ABC news, “and they said yeah they were expecting a delivery and the driver was late.”…

The ABC piece added: “Sheriffs say what’s frightening here is the safety of Wal-Mart’s pharmacy customers.”

You can pick your jaw up off the floor now. It’s all true.

Al Norman, who wrote the Huffington Post article, sums it up this way –

Wal-Mart has been in the pharmacy business since 1978, and has over 4,264 pharmacy locations in the U.S. alone. The company boasts of its high-tech software system that gives its pharmacists access to a “huge database” across the country. Yet a company with this sophistication is obtaining narcotics from a carload of illegal “couriers” barreling up Route 15 at 96 miles per hour.

When I read the piece, I couldn’t help but think, “Can you imagine if a story like this broke in the media involving a Canadian online pharmacy?”

And yet for Wal-Mart, it’s barely a blip on the radar.

We speculated last week that the big health insurance companies and their PBMs (pharmacy benefit managers) may soon attempt to force employees toward mail-order drugs. It’s certainly a real possibility after the PBM Express Scripts began providing mail-order delivery as a default option for employer-based health plans.

As I predicted then:

1. Soon, all other PBMs will offer the same program.
2. Then, one PBM will come up with a program that makes participation in the mail-order program mandatory in order for employees to receive coverage — in the name of employer cost savings.
3. That will become the dominant model for employer-based prescription drug insurance.

I then added, forebodingly:

Now, I haven’t factored in the uproar that this would cause with the Wal-Marts, Rite Aids and the like…

Well, you can forget Rite Aid, because they’re going to go out of business anyway. But Wal-Mart, that’s another story. You could bet they weren’t going to take this sitting down.

So how to fight the PBMs? How about by bypassing the health insurance companies altogether and taking your pitch straight to employers?

As Kaiser posted today:

Wal-Mart on Friday announced that it is in negotiations to expand to several other companies a generic drug purchasing pilot program it currently runs with Caterpillar…

Under the pilot program, Wal-Mart waives the $5 copayment for generic drugs for Caterpillar employees when they purchase their medication at Wal-Mart or Sam’s Club pharmacies. According to the [Chicago] Tribune, the incentive to fill prescriptions at Wal-Mart or Sam’s Club pharmacies boosts Wal-Mart’s pharmacy business and pushes more potential customers into their retail stores, where they might purchase other items.

According to the Tribune, the “most radical aspect of the test … is the threat of unraveling how the health care industry buys and sells prescription drugs.” As part of the program, Caterpillar has a contract to purchase drugs for employees directly from Wal-Mart, bypassing the need for a pharmacy benefits manager…

Walgreens, meanwhile, has announced that it is pursuing a strategy similar to Wal-Mart’s.

This is beautiful, folks. It almost certainly means that the costs of generic drugs will continue to fall in the United States, which is great news. And perhaps the competition between retail pharmacies and PBMs will squeeze some of the inefficiencies out of the current system, reducing administrative costs as well.

Unfortunately, this battle can do little to reduce the prices of brand-name prescriptions, which are the real reason Americans can’t afford to pay their drug bills anymore. Just as drugmakers can dictate their monopoly pricing to the consumer, they can also dictate it to the middlemen.

Still, Wal-Mart vs the PBMs will be fun to watch.

Rite Aid is a $24 billion company operating more than 5,000 drugstores in 31 states, making it the third-largest pharmacy chain in the United States. But unless this overpriced retailer receives some bailout money from heaven (’cause it’s sure not coming from Washington), the year 2009 may be its last.

Motley Fool has just put it on its list of 15 companies that might not survive the year. Says the Fool:

Rite Aid. (Ticker symbol: RAD; about 100,000 employees; 1-year stock-price decline: 92%). This drugstore chain tried to boost its performance by acquiring competitors Brooks and Eckerd in 2007. But there have been some nasty side effects, like a huge debt load that makes it the most leveraged drugstore chain in the U.S., according to Zacks Equity Research. That big retail investment came just as megadiscounter Wal-Mart was starting to sell prescription drugs, and consumers were starting to cut bank on spending. Management has twice lowered its outlook for 2009. Prognosis: Mounting losses, with no turnaround in sight.

Rite Aid’s story, full of waste and mismanagement, is a classic illustration of why Americans save so much money through online and mail-order pharmacies. Whether these pharmacies are based in the United States or Canada, they require a fraction of the overhead of a big chain pharmacy — particularly one as poorly run as Rite Aid.

Rite Aid has been in trouble as far back as 1999, when it was busted by the news media (and investigated by state regulators) for questionable business practices like selling date-sensitive products well past their due dates. Rite Aid also had a doozy of an accounting scandal that led to jail time for several top ranking execs, including CEO Martin Grass.

Like many bloated Fortune 500 corporations, Rite Aid tried to put lipstick on the pig by acquiring competitors like Eckerd. It’s a quick way to boost your top line to impress your stockholders without actually doing anything intelligent to help your customers. Rite Aid went deeply into debt in the process, and now they’re on death’s door.

In addition to its own incompetence, Rite Aid has been hurt badly by the trend toward mail-order pharmacies and by Wal-Mart’s $4 prescription drug plan, which savvier retailers (including finally CVS late last year) have copied.

In its own backward way, Rite Aid has been trying to catch up with its lower-cost competitors, but it’s almost undoubtedly too little, too late.

Rite Aid does frequently offer short-term promotions for consumers who transfer their prescriptions (for example, If you transfer two prescriptions to Rite Aid, you receive a $25 gift card for each — a $50 value.) However, their Rx Savings Card only entitles you to an $8.99 price for select generics — more than twice as much as Wal-mart and many others now charge.

That’s the best you’ve got? Good luck with that, Rite Aid. We’ll see you in the business obituary section.

Harris Teeter, the North Carolina-based supermarket chain with 177 stores in the southeastern United States, has matched discount price programs at Wal-Mart, CVS, Target, Walgreens and Kroger, announcing that it is now offering customers a 90-day supply of over 300 generic drugs for $9.99.

Customers must purchase a $5 drug savings card, good for one year, to take advantage of the discount. The plan doesn’t apply to prescriptions covered by insurance.

We welcome the continuing trend toward low-cost generics. It’s good to see some real price competition over prescription drugs, something that was sorely lacking before Wal-Mart announced its $4 generic drug program.

Unfortunately, the millions of Americans who are struggling to pay their prescription drug bills each month know that the problem has never been generic medication, but brand-name drugs that aren’t among the 300 to 400 on the lists of the discount retailers.

That’s the problem that Wal-Mart can’t solve. Only the government can fix that one.

As Wal-Mart has taken the lead in lowering prices on generic drugs among brick-and-mortar retailers, the major drug chains have been slow to respond. Walgreens came around first, and now CVS has finally responded — with a $9.99 price point on a 90-day supply of about 400 different medications starting later this month.

Despite the fact that CVS is a day late and dollar short on reducing prices on generics, its announcement got some surprisingly high-profile media coverage from the likes of the Dallas Morning News and the Los Angeles Times. Why, you might wonder? Because of an added gimmick that won’t do much for healthcare consumers — but that has obviously been good for PR.

The gimmick? To “bundle its program with medical care from its in-store clinics.”

Sounds great — till you realize what this “bundle” consists of. You pay $10 per year for a CVS Health Savings Pass, and you get the lower generic drug price and a 10 percent discount at CVS MinuteClinics.

Ten whole percent? Consider our healthcare crisis solved.

Of course, the tens of millions of Americans who are struggling to pay their prescription drug bills each month know that the problem has never been low-cost generics, but drugs that aren’t among the 400 on the lists of Wal-Mart, Target, Walgreens, Kroger or CVS. The drugs that bust family budgets aren’t on anybody’s list.

And paying a little less for a visit with a nurse in the back corner of a drugstore will do little to ease that pain.

One of the biggest advantages of shopping for prescription drugs online is price transparency, which empowers the consumer to easily find the best price among available options.

As healthcare consumers well know, it is very difficult to comparison shop among brick-and-mortar pharmacies, because pharmacies typically don’t advertise their prices for prescription drugs (with the exception of the Wal-Mart generic drug program and similar programs, which generally include a list of covered drugs on the retailer’s Web site.)

Because it’s difficult to compare prices, particularly for expensive, brand-name drugs, most consumers buy at their corner drugstore, assuming the price isn’t much different from the next corner — or the other side of town. This simply isn’t the case. What’s worse, the disparities in pricing disproportionately affect poorer people.

According to a new study appearing in the Health Services Research journal:

Four of the most widely prescribed drugs in the United States can cost 15 percent more on average in the poorest neighborhoods of Florida, according to a study comparing retail pharmacy prices around the state. Part of the explanation is the high proportion of independent pharmacies in poor ZIP codes that charge the highest prices for Nexium, Advair, Plavix and azithromycin…

In contrast, the study shows that chain pharmacies are less expensive and less likely to vary their prices based on ZIP code. However, they are also less common in poorer areas. The authors noted that some independent pharmacies in poor neighborhoods did charge prices similar to chain pharmacies, but that issues such as health literacy, finances and transportation could limit consumers from shopping around…

Even small price increases have negative consequences, and two earlier studies found that the cost of prescription drugs discourages uninsured and poor people from filling their prescriptions. As a result of not controlling their health, they spend more time in emergency rooms.

The researcher behind the study concludes:

“Insuring the uninsured is a priority. However, uninsured people who pay retail prices for their medications and struggle with health care costs should not face higher prices because of where they live. Even though these variations are based on data from only one state, they deserve further investigation.”

eDrugSearch.com will soon be releasing our first e-book, 99 Ways to Save Money on Prescription Drugs. To whet your appetite, here are 10 ways to save, courtesy of the Cleveland Plain Dealer (who interviewed Dr. Edward Jardini and Steven Findlay, managing editor of Consumer Reports Best Buy Drugs, for their story):

1. Start with a heart-to-heart with your doctor … Tell him or her, honestly, how much you can afford to spend on medication … In the end, you may find you just don’t need some of the drugs you’re taking.

2. Ask about generics. These are usually much, much cheaper than brand-name drugs, says Steven Findlay … The cholesterol-lowering drug Lipitor, he says, is a good example. It costs $95 to $100 a month. A generic alternative, such as Simvastatin, is about $30.

3. Check out the $4 generics many stores now offer. Those lists expand periodically, Findlay says. And more stores are offering them…

4. Don’t forget over-the-counter medicines. … Consider them especially for allergies and occasional bouts of insomnia and heartburn.

5. Don’t “ask your doctor” like all those ads tell you to… Advertised drugs are expensive, and we often don’t need them.

6. Be cautious about accepting free samples. Drug companies don’t give samples to doctors for every medication, just those that bring in the greatest profits…

7. Search the Web. You probably won’t find generics for less online, but you can save 10 to 30 percent on some brand-name medications if you buy them from reputable drugstores that sell over the Internet, Findlay says. “You will cut the brick-and-mortar — the overhead — costs,” he says. Shop around, though. Prices vary.

8. Turn to Canada. Generics are cheaper here than there. But when it comes to brand-name drugs, you can save significantly, according to Findlay, especially if you’re on two or three medications. You can find Canadian pharmacies online, too. “Don’t go to the fly-by-nights,” Findlay says. “Go to the biggies. They’re not too hard to find.” And don’t worry. Buying drugs from Canada won’t get you in trouble with the law, Findlay says, as long as you’re buying them for yourself and you have a prescription.

9. Look into Prescription Assistance Programs. Pharmaceutical companies typically offer them to provide free or low-cost drugs to people who lack prescription drug coverage … But you must meet certain income guidelines, and the application process can be time-consuming…

10. Consider pill-splitting. Sometimes a pill that’s double the dose isn’t double the price. So you can split it in half and save money. Be careful, though … always check with your doctor first.

We all know — or should know — by now that the Medicare prescription drug benefit (Medicare Part D) was crafted with the needs and convenience of Big Pharma, rather than patients, in mind. That’s why it’s so unwieldy for the consumer.

The worst part about Medicare Part D is the so-called “doughnut hole,” described by the Wall Street Journal as “the notorious gap in coverage … where (beneficiaries) generally must begin paying the full cost of their medicines. The doughnut hole kicks in when total drug expenditures by the beneficiary and the plan reach $2,510.”

Another egregious element of Medicare Part D, which has gotten less attention, is private “pharmacy benefit managers” charging Medicare beneficiaries MORE for prescription drugs than they cost at the pharmacy! These middlemen are ripping all of us off, too, since the taxpayers are picking up most of the tab. And by charging inflated prices, they push Medicare beneficiaries into the doughnut hole sooner.

Medicare is trying to fix the problem, but in the meantime, advocates for the elderly are advising them to buy at least some of their drugs outside the Medicare Part D plan.

Advises the Wall Street Journal:

Medicare drug-benefit participants buying drugs should consider checking low-price sellers of generic medications, such as Costco Wholesale Corp. and Wal-Mart Stores Inc., to see if their retail prices are lower than those in the insurance plan.

That is what Len Steinberg of Scottsdale, Ariz., did, and he found that Costco’s retail price for his generic nasal spray was about half of the drug’s total cost under his plan.

Mr. Steinberg, a 73-year-old retired employee-benefits consultant, says he now pays cash for certain cheap generics at Sam’s Club and Costco, rather than using his drug coverage. That allows him to avoid the doughnut hole and continue receiving coverage for his more expensive branded medications, he says.

Another option, of course, is to buy your medications from licensed Canadian pharmacies, where prices are on average about 50 percent less than the same drugs at U.S. pharmacies.

Image source: Senior Focus

WLWT-TV in Cincinnati warns that generic prescription programs can create issues for patients.