Most of us have suffered this sticker shock: You show up at the pharmacy to pick up a new prescription and are astonished at the price- and that’s even if you have insurance. Those with modest or no insurance face a more daunting prospect, including forgoing a costly medication even if it’s considered vital. AARP recently conducted a survey of the impact of high prescription drug prices on patient medication compliance and the results are not surprising: Among people under age 64, 28% of the respondents stated they don’t follow medication regimens because of cost, and instead use a number of substitute tactics when it comes to taking prescription drugs. Those can include everything from delaying the start, to skipping doses to taking less than is prescribed. In some cases, including the ever more expensive insulin required by diabetics, the results can be deadly. If you want to find out what’s going on in your state, take a look here. Of course, to find out prices and comparison shop you can go to GoodRx.com or Drugs.com to research cheaper generic drug options. And next time you’re at the doctor’s office, ask if they have drug-pricing software built into their electronic systems so that you can discuss options and costs the moment a drug is prescribed.

Recently, Kaiser Health News published a post about the ins and outs of seeking cheaper medications outside of the United States. Words of warning were tempered with reality: While it’s technically illegal to purchase medications by crossing the border or purchasing from an online international pharmacy, the likelihood of being prosecuted is minimal, especially when the quantity is clearly for personal use and the drug isn’t unreasonably dangerous to the user. The article references websites that provide valuable information about pricing and legitimacy of online international pharmacies (try checking out PharmacyChecker.com). But it concludes with some useful advice: Generic drugs purchased in the US can often be cheaper than those purchased from places like Canada. So before you look beyond our borders, engage your physician in a conversation about costs and alternatives.