From Our Family to Yours

Cutting Rx Costs

Paying too much for prescriptions? There are several ways you can reduce your out-of-pocket expenses. See our survey of online and local pharmacies for cost-cutting strategies.1

Welcome Dr. Harden

Keith L. Harden, M.D., recently joined the medical staff of the

Center for Primary Care South. Read more about CPCs newest physician.

Vaccine Shortage

Influenza vaccines are in short supply this season. Find out more about the shortage and what to do if you get the flu.

This Newsletter Brought to You by the Physicians and Staff of The Center for Primary Care

Smart Shopping Can Cut Rx Costs

If you find the high cost of prescription medications frustrating, you may be happy to know that you can significantly stretch your prescription dollar by being a smart shopper.

As a consumer, you have choices that can make a big difference in how much you pay for prescriptions. For example, you decide who fills your prescription and whether to buy a brand-name medication or the generic equivalent. Knowing how to use these and other choices to your benefit may require a little cost-and-service research on your part, but the rewards are well worth the effort.

To illustrate how much money you can save by being a smart shopper, we investigated the costs of four widely used medications from six different pharmacies. The medications we evaluated were Paxil (antidepressant), Lipitor (cholesterol-lowering), Cardizem CD (for the heart), and Ceclor (antibiotic). We priced each medication at two local pharmacies (Eckerd and CVS) and four online pharmacies (,, [AARP], and

We identified three cost-saving strategies you can use to reduce your prescription costs: request a generic instead of a brand-name medication when filling a prescription; ask about the availability double-strength tablets that can be halved; and comparison-shop at local, mail-order, and online pharmacies before deciding where to fill your prescription.

How Much Can I Save by Being a Smart Shopper?*

For Paxil and Lipitor, shopping online and buying double-strength tablets were two good strategies for saving money. (There are no generic equivalents for either medication). Purchasing a months supply of Paxil (20 mg) from for $65 instead of from Eckerd for $79 saves $14. If you prefer to shop at a local pharmacy, purchasing 40-mg tablets to be broken in half instead of 20-mg tablets can save up to $35 per month ($44 vs $79 for a 30-day

supply). The best buy for Paxil, however, combines both strategies. Purchasing 40-mg tablets from costs only $68. Since the 40-mg tablets broken in half provide a 60-day supply, the cost per month is only $34, which is $45 per month less than the most expensive choice.

Using the same cost-cutting strategies, the savings for Lipitor (10mg) are similar. Buying Lipitor online ($50 from vs. $72 from CVS) reduces the cost by as much as $22 per month. From local pharmacies, a months supply of double-strength tablets to be halved costs as little as $51. Combining these two strategies buying double-strength tablets from online suppliers again is the best buy: as little as $39 for a months supply from

In checking the listed prices for Cardizem CD (120mg), the online pharmacies currently offer the lowest prices: $35-$39 compared with $45-$46 from local pharmacies. It is worth mentioning, however, that, which currently has the lowest price ($35), quoted a much higher price ($46) only 7 months ago, suggesting that listed prices may fluctuate. The best buy in our sampling is a generic equivalent of Cardizem CD from (Diltiazem, $24), which is $22 less than the higher-priced brand name.

For Ceclor (250 mg), lists the best price on the name-brand drug ($62). If you want to fill your prescription locally, the best buy is the generic equivalent from CVS (Cefactor, $43). The best overall deal on this medication in our survey is the generic equivalent from (Apothecon, $19). This product is significantly ($12) less than other generics ($12 less) and $68 less than the most expensive name brand.

Should Cost Be My Only Consideration?

How you choose a pharmacy depends on what is important to you. Online pharmacies usually offer the lowest price, but if immediate availability, convenience, and personal service are important to you, or if there are special circumstances, it would be wise not to base your decision on cost alone. Instead, consider which provider best serves your needs and preferences. A

local pharmacy may be the better choice for short-term medications, for example, or when the optimal dosage for long-term medications has not yet been established.

What is the Process of Ordering Online?

Ordering online is easy enough, but there may be unavoidable delays, which can be a problem if a prescription is needed immediately, as with antibiotics. The steps involved in ordering from an online pharmacy likely vary from company to company, but heres the process used by one of our survey pharmacies.

Based on ordering information provided by, new customers must supply health and insurance information to the online pharmacy. This is a one-time requirement that is handled online, but the verification process can take 2 to 3 days.

The first time you fill a prescription from an online pharmacy, you can place the order one of three ways. The physician can fax the prescription (fastest), you can mail the original prescription (can take 3 to 5 days), or the online pharmacy can call your doctor (can take up to 5 days).

Once the order has been processed (1 to 2 days), it is sent to you either by standard shipping, which is free but can take up to 5 days, or you can request 2-day or overnight shipping. Using the latter, you will receive your prescription in less time (1 to 4 days), but youll have to pick up the tab for shipping ($6 to $12).

How Can I Save If I Prefer to Shop at Local Pharmacies?

Online prescription spending is expected to soar from $200 million in 1999 to $9.8 billion in 2004, but a recent study shows that most consumers still find buying in traditional stores more convenient. If you are among this group, it is still possible for you to save by being a smart consumer.

Be sure to ask local pharmacies about discounts. CVS, for example, gives a 10% discount to senior citizens age 60 and over. Eckerd offers a HealthCare Discount Plan, starting at $6.50 per month, that can save subscribers up to 30% off the cost of prescriptions.

Generic equivalents are exactly the same as brand-name medications but are less expensive. In our survey, one generic equivalent for Cardizem CD costs only $24 compared with $46 for the brand-name product. For Ceclor, the difference is even more dramatic: $19 for the least expensive generic compared with $87 for the brand name! Since pharmacies usually carry only one or two generics for brand-name prescriptions, it is a good idea to investigate the cost of generics at several pharmacies before making a decision.

Buying double-strength tablets (to be halved) can also be an effective strategy for some drugs with no generic equivalents, such as Paxil and Lipitor.

In a Nutshell . . .

Cutting the cost of your prescription medications isnt as complicated as it might seem. You just need to remember a few key points:

Shop around at local,online, and mail-order pharmacies. It is easiest to do this by phone and/or computer, if you have Internet access. Before you make a decision, remember to consider factors such as personal service, convenience, and immediate availability along with the price of the medication and, when applicable, shipping costs.

Ask your doctor if the medication prescribed for you can be purchased in double-strength tablets that can be broken in half. Inquire about other cost-cutting measures.

Check with your insurance company to see if it provides or recommends a mail-order pharmacy or other prescription drug outlet that offers competitive prices.

Buy generic equivalents whenever possible. They are exactly the same formulation only less expensive.

When you are comparison-shopping for a pharmacy, dont limit yourself to the ones represented in our investigation. There are many others to choose from and some may offer more of what youre looking for than the ones included in this survey.


Source: Eckerd and CVS pharmacies, Augusta, Ga. information supplied by pharmacists; websites;; (AARP);; Online health spending to soar; barriers remain, The Augusta Chronicle, January 26, 2000, p 2A.

CPC Physician Profile: Dr. James Mobley of CPC Evans

It would seem that Jim Mobleys career course was set in place when he received a full scholarship in electrical engineering to Clemson University, but that was not to be. Along the way, his attention turned to medicine and caring for people instead of electrical systems, and that resulted in a career in family practice.

His education, military service, and medical practice have taken him many places – Frankfort, Germany; Tacoma, Washington; and Anchorage, Alaska, for example – but eventually brought him back home to an area where he feels as native as the pine tree. For 20 years now, he has practiced medicine in west Augusta and feels fortunate to be living and working near his family roots and having the privilege of caring for several generations of some families.

The only child of Thomas Mobley, a mill worker and part-time farmer, and his wife, Gerrell, a homemaker, of Anderson, S.C., Jim had always been a bright student. High school came easily to him, requiring little of his free time. So at age 14, he started working in the cotton mills in Anderson, where he says he learned a great deal about people.

Working in the mill gave Jim enough fun money to indulge his fascination with sports cars. I was infected with this bug in early childhood, he recalls. One of our neighbors had bought a new 1954 Corvette that I thought was the most beautiful thing I had ever seen in my life. That began a lifelong love affair with automobiles that led him that led to his owning an array of sports cars, including Jaguars, Ferraris, MGs, Austin Healys, a Lotus, and a Dodge Viper. Not all at the same time, of course. Mostly sequential monogamy, he explains.

Restoring cars to their original splendor is a particular pleasure for Dr. Mobley. He has breathed life back into a 1932 Ford and a 1956 Corvette, and currently, is resurrecting a Triumph TR8. He says restoring cars involves problem solving, not totally unlike caring for patients who are sick. His hobby also creates opportunities for adventure. One of his all-time favorites was, as a young man in his late-20s, driving a light blue Ferrari from London to Naples across France, Germany, Austria and Italy.

After high school, Jim left his hometown for Clemson University, where he began his studies in electrical engineering. It was not until his junior year that he realized he was destined for medicine instead. The switch is not such a broad leap of interests as one might think. Medicine and engineering are both problem-solving disciplines, he explains. Many people in medicine have engineering backgrounds.

Having finished his medical education early at the Medical University of South Carolina in Charleston, Dr. Mobley was midway through a pathology residency when he was called into active military service. Despite his training in pathology, the Army had another path in mind for him. They brought me in to be a general medicine officer, Dr. Mobley explains, and so he was. After serving in this capacity, Dr. Mobley had a change of heart. Pathology, the study of disease, is a broad, good background for family practice because family physicians have to know about disease processes in the entire body, he explains, but family practice enabled him to work with people, which he had come to enjoy immensely. He eventually completed a family practice residency at Madigan Army Medical Center in Tacoma, Washington.

While in the Army, Dr. Mobley served as head of the largest emergency room in Europe in a military hospital there and provided emergency medical services to the Cuban boatlift people in 1980. He appreciates how his Army experiences broadened him as a physician. The Army Medical Corps at that time had very experienced people and I was able to do things that would be unimaginable in the private world, he says. It was an excellent extension of my education.

Eventually, young Dr. Mobleys service to the military brought him to Augusta to be a teacher in the family practice department at Fort Gordon. By this time, he was married and had two sons, Rhett and Tom, now aged 31 and 26, respectively. When he resigned from the Army in 1980, Dr. Mobley settled in Columbia County and set about establishing a family practice at a time when the area was much less developed, he recalls. I was probably the first residency-trained family physician on the staff of Doctors Hospital.

When Dr. Mobley says he built a practice in the Augusta community, he means not only growing a patient population but also building of the brick-and-mortar type. I am proud of having built two offices much of it with my own hands, he says. His first private practice office was in a house on Columbia Road which he extensively renovated. His second, where he practiced for 10 years, was an even greater challenge. I tore off the roof and added an upper story, he says, and also became proficient in hanging sheet rock and framing treatment rooms.

From his Washington Road private practice, Dr. Mobley next joined Paul Fischers practice group in 1995, where he continues to serve patients of his former private practice as well as newcomers. Describing it as the nicest working environment he has ever had, bar none, Dr. Mobley says, While I did not hammer a single nail on this one, I feel I have been a part of bringing the finest in primary care to this area, he says.

Dr. Mobleys life is a broad and colorful tapestry of experiences, but his conversation always comes back home and medicine. My greatest honor is the trust implied by caring for three to four generations of many Columbia County families and my greatest pleasure is being a part of my surroundings, he says. I will continue enjoying what I always have: I love my job and I love seeing patients.

Dr. Keith L. Harden Joins CPC South

The Center for Primary Care is proud to introduce our newest physician, Keith L. Harden, MD. Dr. Harden is board-certified in family practice.

Dr. Harden is a 1995 magna cum laude graduate of Morehouse School of Medicine in Atlanta. Following graduation, Dr. Harden completed his residency at the Halifax Medical Center Family Practice Residency Program in Daytona Beach, Florida.

Dr. Hardens areas of special interest include mens health issues, geriatrics, skin procedures and spiritual mental health. He and his wife, Sheila, have two sons, ages 2 years and 6 months.

Dr. Harden began his practice with the Center for Primary Care on November 1, 2000, at the South Augusta office, 2011 Windsor Spring Road. To make an appointment, call 798-1700.

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Shortage of Flu Vaccine Hampers Immunization Process

Were well into influenza season already but instead of hearing that its time to get your flu shot, youve probably been hearing more about a shortage of vaccines. Unfortunately, its true. Earlier this year, influenza vaccine manufacturers notified the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) to expect not only a nationwide shortage in the supply of vaccines this season but also delays in the distribution.

The shortage and delay have resulted from the manufacturers difficulty in growing one of the three influenza virus components. Other manufacturing problems have also affected the production of flu vaccines.

The Center for Primary Care is already feeling the effects of this shortage, although we are doing all we can to acquire the vaccines needed for our patient population. According to Rhonda Brown, CPC Clinical Supervisor, the three offices together usually have enough to vaccinate 1500 patients. This year, weve been promised enough for only 250 patients, but we have contacted other companies to try to get more.

This means there will probably not be enough of the vaccine for everyone who usually gets vaccinated. People at high risk for respiratory problems, those with compromised immunity, and the elderly should definitely  be vaccinated, she says, because they are the most vulnerable to complications associated with the flu.

There is no delay or shortage associated with the pneumonia vaccine, which is available at CPC now. Appointments are not needed for either flu or pneumonia vaccines, although for flu shots, it is advisable to call CPC first to be sure it is available.

If you do end up with the flu this season, antiviral medications can ease symptoms and shorten the duration of your illness. Relenza (zanamivir) and Tamiflu (oseltamivir) are effective against influenza types A and B but to be effective, they must be taken within 48 hours after symptoms develop. Relenza is not recommended for patients with underlying asthma or chronic obstructive pulmonary disease. Two other antivirals, amantadine and rimantadine have been approved for the prevention of type A influenza and can ease symptoms but are associated with adverse reactions affecting the central nervous system. These are used to prevent outbreaks in at-risk populations and are not generally used in healthy people.

If you think you have the flu, call your CPC physician as soon as you start experiencing flu symptoms so we can take whatever steps are possible to reduce the effects and length of your illness.

Source: Centers for Disease Control and Prevention (CDC) Office of Communication, Atlanta, Ga.: Flu Season 2000-01 Flu Vaccine Supply and Flu Drugs (Antivirals), June 22, 2000.