Healthcare is often expensive, but many times you can get the same good results and spend much less money.

How? With the combination of information and communication. By knowing your plan's formulary and sharing it with your physician, you both win. You get your prescription more quickly and for a lower co-pay; your doctor's office gets fewer phone calls to return.

1. Generic medicines are much less expensive than brand name ones. In allergy and asthma, many brand name expensive drugs are no better than older versions they replaced. For example, Clarinex is "improved" Claritin, or loratadine. Generic loratadine costs 5-10 cents/pill. They work about the same. Xyzal is "improved" Zyrtec, or cetirizine. Cetirizine as a generic costs about 5-10 cents/pill. The nasal steroid, Flonase, is now available as generic fluticasone. It is much less expensive than Veramyst or Nasonex. (However, fluticasone does cause more nosebleeds than the newer sprays). Astelin is now generic azelastine, but we get samples for the new, improved Astepro, which costs more. The difference: they added Splenda to Astelin to help disguise the taste and got a patent for the new drug, Astepro.
2. If you prefer the brand name drug, or if there is no generic, see if there are discounts of some type, either a co-pay voucher or discount card. Nasonex has a $15 discount at www.Nasonex.com. Look for similar savings from other nasal steroids Veramyst and Omnaris. Asthma inhalers such as Advair , Symbicort, and Proventil HFA all have discounts, as do the nasal antihistamines Astelin and Patanase. Check the sites for Singulair, ProAir, Ventolin, and any other brand name medicine you take.
3. Some over-the-counter medicines were the hot, brand-new items a few years back. Prescription Pataday and Bepreve are expensive, but often OTC Alaway works just as well, for about $12 per 60 day bottle. OTC loratadine and cetirizine are the least expensive at Sam's Club or Costco, around 4 cents per pill.
4. Many pharmacies fill a 30 day supply of certain generics for $4.00. Look for benzonatate, loratadine, promethazine, albuterol nebulizer solution, and others on these lists.
5. Target sells the small version of Ventolin HFA for $8.00; WalMart has it for $9.00. It only has 60 puffs instead of 200 puffs, but the regular ones usually sell for $45-50.
6. If you shop at Mission Allergy, here's how to save a little money: Mention Code: "DM5" before ordering. You'll get a 15% discount on Premium Microfiber encasings, or a 10% discount on Barrier Fabric II.

In 1988, when managed care was ramping up, the CEO of Methodist Hospital said: You can have excellent quality health care, it can be affordable, and you can have universal coverage. Now pick any two you want; you can never have all three. We will work with you to try to get all 3.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.