First and foremost, know what you are using, how it works, and what to watch out for. MedlinePlus from NIH provides information on drugs and supplements. It covers why a drug is prescribed, how to use it, other uses, precautions to take, dietary instructions, side effects, how to store and dispose of it, brand names, and more. Information is also available on drugs.com, webMD.com and MayoClinic.org.

a) Many drugs have interactions with other drugs, supplements, food and drink. Your doctor can explain them, and your pharmacist normally checks for them. But ultimately it is up to you to avoid them.

b) All health plans use formularies to control their costs. Formularies also confuse people and doctors alike. That makes it incumbent on you to understand the one your plan uses. They have multiple tiers with different costs (copayments or coinsurance). The lower tiers have generic drugs. The higher tiers have brand and specialty drugs. Sometimes a less expensive alternative is in or outside of the formulary, and drugs also change tiers. Only you will be able to catch that.

c) Understand your reactions to your drugs. Your doctor can help you adjust dosages, alternatives, delivery mechanisms, etc., which can improve both cost and performance.

Health plans employ pharmacy benefit managers (PBM) to negotiate large drug purchases at lower costs.

a) Plans and PBMs also use mail order pharmacies to fill prescriptions in larger amounts, usually 3 months instead of 1. That both drives down the delivery cost and drives up convenience for you.

b) PBMs and pharmacies provide “pill packs”. They sort your pills by day (and time in needed) and pack them together by date/time slot. It’s more convenient, may cost more, but improves compliance with a medication schedule so they work better.