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A decade ago, independent pharmacies were an endangered species, but they rebounded after many states adopted "any willing provider" laws, which require insurance companies to take into their networks any pharmacy willing to accept the insurer's reimbursement rate. Unfortunately for consumers, independent pharmacies are again being threatened, this time by the federal government, which administers Medicaid and Medicare, including the Part D prescription-drug program for seniors. Independents rely on government reimbursement for almost 40 percent of all payments, and the government is a notoriously slow payer, says Lisa Camooso Miller, a spokeswoman for the National Community Pharmacists Association, a trade group. "Our members have been struggling," Miller says. The future of independents will depend largely on their interaction with government officials to ensure a more prompt payment system so the druggists, in turn, can pay their bills.
Chains: You might have to wait. Americans still buy most of their medications from conventional chains such as CVS and Walgreens. Chains tend to accept lots of insurance plans, many stores never close, and you can use the phone or computer to order refills you pick up at the branch of your choice, depending on the chain, or have mailed to your home. (Shipping charges are low or non-existent.) The bigger chains seem to sit on almost every corner, and they've morphed into grocery stores.
At their Web sites, you can typically create a secure profile, track prescribing history, print records, e-mail questions to the pharmacist, bone up on health information, research drugs, and sign up to have prescriptions refilled automatically. Chains also are more likely than other types of stores to let you check prices online. Each chain in our drugstore comparison has a central database, so your records are on file at any store.
Supermarkets: Shop while you wait. About 10,000 supermarkets include a pharmacy, and some are open 24 hours a day. Druggists in supermarkets fill fewer prescriptions per day on average than in other types of stores, so in theory, there can be a closer relationship with patients.
Supermarket-pharmacy Web sites are usually not as comprehensive as chain-drugstore sites (you often can't check prices), but you can typically renew, fill, or transfer an existing prescription; research drugs and interactions; and read articles about healthful living and preventing illness. At Safeway, you can have your prescription filled online and delivered with your grocery order.
Mass merchants: Seek special deals. Of readers who patronized big-box stores, 8 percent lacked prescription-drug coverage, which reflects the stores' focus on price. For example, Wal-Mart and Target sell a 30-day supply of more than 300 drugs, primarily generics, for $4 each. At Kmart, if you're 50 or older, you can apply for a free GoldK card, which the company says offers savings of up to 10 percent on every brand-name prescription or as much as 20 percent on generics. In our price study, Costco was the least-expensive seller of all, and you needn't pay its $50 annual fee to fill prescriptions there. If you do join and enroll in the Costco Member Prescription Program (a free benefit for uninsured members), you can save more.
• Wal-Mart scored significantly lower than the other mass merchants.
• Mass-merchant Web sites tend to be similar to supermarket-pharmacy sites.
• Online/mail order: Save on refills. Some Web sites have no store counterpart; others do. When walk-in stores in our drugstore comparison had Web affiliates, overall satisfaction scores for the two venues were similar.
To order online, you typically enter the drug name and quantity, and a pharmacist confirms the prescription with your doctor. There's phone and online support, and you can e-mail a pharmacist.
You can usually pick up an online order at a store of your choice within a couple of hours, though you might have to pay the store price, which can be higher than the Web price. Otherwise, you can choose standard shipping for little or no extra charge (allow 5 to 10 days). Refrigerated medicine must be sent express, which can be costly. There are special requirements for the shipment of medications that contain narcotics.
Online drugstores will usually let you order a 90-day supply of medications to treat chronic conditions such as high blood pressure. In the past, many walk-in stores limited customers to 30 days' worth. But that's changing, and you might be able to order a larger supply from your neighborhood store.
In our drugstore comparison's price study, the Web sites AARP.com, Walgreens.com, and CVS.com were among the cheapest sources of medicine.
If you're unfamiliar with a site, be sure it's licensed in your state. Check by going to your state's Board of Pharmacy Web-site. Some sites that are licensed and in good standing with state regulators participate in the National Association of Boards of Pharmacy's Verified Internet Pharmacy Practice Sites program and display a VIPPS seal. The program is voluntary. If you click on the seal, it should link you directly to the NABP site (www.nabp.net), offering assurance that the seal is real.
The survey by the Consumer Reports National Research Center
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