10/05/2010 02:12 pm ET | Updated Nov 17, 2011

Big Box Prescription Bargains -- Less Than Meets the Eye?

My colleague, a respected pharmacist for a non-profit organization, told me about a few experiences he's had recently with clients. One patient, given a new prescription for a second drug to treat his high blood pressure that the non-profit pharmacy would have to order, opted to try a local big box store instead, hoping both his old and his new medications, available as generic drugs, would only cost him the advertised "four bucks." Another patient, who'd been prescribed a drug still under patent and not available commercially in generic form, insisted that using the chemical name of the medication would allow the big box store to charge her only $4 for her prescription.

Both patients ended up surprised that the advertised "deal" wasn't the bargain they'd hoped for. The patient with high blood pressure was able to get his first medicine at the big box store for a few dollars less than the non-profit pharmacy could afford to sell it. The new prescription's price was not $4, but close to $30, much more than the cost at the non-profit pharmacy! The second patient was upset to discover that the big box store's price for her medication, unavailable generically, was over $100 a month! Both patients ended up returning to the non-profit pharmacy long-term for a better overall "deal."

It's understandable that in today's tough economic times, everybody is bargain hunting, trying to save pennies here and there. There is no question that many of our medications are expensive because pharmaceutical companies spend millions of dollars on research and development and even more on corporate administration and marketing. Countries with single party payer systems that include regulation of drug costs offer many of the same medications at a fraction of the cost. But, the free market in the U.S. ensures that the cost of medications for most consumers is far, very far, from free.

Bargain hunters seeking to limit their spending are wise to consult with their doctors about medication alternatives that may be equally effective and less expensive, including generic versions of brand name drugs. But, it's also good to be wary about advertised retail bargains that may have you spending more money than you intended or can afford. Businesses seeking to enhance traffic and sales often use "loss-leaders," in other words, attractive bait, to get you into their stores.

"Bait and switch" is an unethical practice through which a retail operation draws you in with a low-priced item and then encourages you to purchase a higher-priced item or one with a higher profit margin by, for example, admitting that the "bait" is unavailable or sold out. But, a store can avoid that ethical precipice by providing you with the "bait" at the price promised, but tempting you with other purchases "while you're waiting" that move merchandise and fill their coffers.

Let's try an honest quiz. Raise your hands. How many of you have been to a big box store and walked out with only one item? Anyone? Anyone at all? Bueller? I certainly haven't. There's always the magazine rack, the jewelry display with the latest earrings, a few groceries I might as well restock on, etc. The antibiotic costs $4 and the total checkout bill is usually much more. Even if the company loses money on the limited list of medications they offer at a low price, they are bound to make up the loss on that new pair of shoes that match your favorite dress.

The bottom line is, unfortunately, the bottom line. Big box stores are in business to make money, not to subsidize your health care. Even if the store avoids other corporate sins such as the exploitation of workers in developing countries, and your conscience allows you to shop at its outlets without guilt, you need to be aware of the man-hours of research and study that have gone into making the seemingly random placement of attractive product displays, advertising messages and price baits as profitably effective as possible.

So, prescription bargain hunters beware. Some helpful tips:

  • A loss leader often means you'll be led to a loss -- of your money on unplanned purchases.
  • If a bargain is too good to pass up, be prepared that there may be a catch. Or a switch.
  • Pre-plan exactly what you're going to purchase when you get into the store. Like Odysseus as he passes the sirens to return home from Troy, steel yourself against the tempting displays and stick to your list.
  • If you are able to buy your product at the advertised low price, and then find your will power fading, remember that that's exactly what the company hopes for. Are you going to fall for their wiles and their wares?