The cost to fill prescriptions can quickly turn into a financial burden, especially when budgets are tight.

Some pinched patients are even going so far as ditching the drug component of their doctors' orders just to save some cash. An October survey by the Kaiser Family Foundation, a nonprofit health policy group, found that 27% of people decided not to fill a prescription in order to save money, up from 23% six months earlier. About 22% reported cutting pills or skipping doses, up from 19%.

These are indeed ominous signs as the economy continues to spiral down. But as with mortgage payments and credit-card debt, there are things consumers can do to save on drugs while maintaining their health.

Here are five strategies to help you cut back on your drug costs.

Take advantage of store promotions

Since 2006, retailer Meijer has offered commonly-prescribed generic antibiotics at no charge. Now several other large supermarket chains are following suit with their own antibiotic giveaways. Last week, Wegmans announced that between now and the end of March it would give a 14-day supply of any of nine generic antibiotics for free to customers with a Shoppers Club card. Giant Food and Stop & Shop are also offering up to a two week supply of free common generic antibiotics between now and March 21.

CVS (CVS) is offering another way to save. A couple of months ago, it launched the Health Savings Pass Program, which aims to help uninsured and underinsured consumers manage health-care costs. Customers pay an annual $10 enrollment fee and can buy a 90-day supply of more than 400 generic prescriptions for $10. They also get a 10% discount on services and screenings at the retailer s in-store MinuteClinic.

Go for generics

Ask your doctor if there s a generic equivalent for your prescription, says Carolyn McClanahan, a former practicing physician and founder of Life Planning Partners, a financial planning firm in Jacksonville, Fla. In most cases, the active ingredients in brand-name and generic drugs are the same; it's the inactive ingredients that sometimes differ, says McClanahan.

Bear in mind that not all medications have a generic equivalent. If that's the case, ask your doctor if there s a generic available for a comparable drug, says Albert Wertheimer, professor of pharmacy administration at Temple University. Say you re prescribed the cholesterol-lowering drug Lipitor. It has no generic version, but competing drug Zocor does. In almost no cases do you do any harm by switching to the first cousin of a medication, says Wertheimer.

Buy in bulk

If you re on medication for a chronic condition, ask for a 90-day supply rather than a traditional monthly refill. It s a better deal, says McClanahan. Just make sure your insurance plan covers prescriptions for that length of time.

Pharmacy programs at major retailers and supermarkets, including Wal-Mart (WMT), Target (TGT) and Stop & Shop, offer hundreds of generic prescriptions at a significant discount, especially when you order a longer-term supply. A 30-day supply typically will cost around $4 while a 90-day supply will cost just $10. Also look into mail-order pharmacies. Many insurers offer lower rates on prescriptions if you order several months' supply through the mail. You can often get a three-month supply by mail for what you'd pay for a two-month supply at the drugstore.

Shop around

Compare drug prices at various pharmacies to see which one sells your prescriptions at the best price. Also, don t be shy about asking for a price match at the pharmacy counter. Many pharmacies will match others prices, but they won t advertise that to customers, says Ted Epperly, a family physician in Boise, Idaho, and president of the American Academy of Family Physicians.

One word of caution: If you get different prescriptions filled at different pharmacies, make sure to tell the pharmacist about all of your medications so they can identify any possible adverse reactions.

Split pills

Pill splitting is another strategy that can help patients save without sacrificing drug effectiveness or safety. Some pills are available at twice the dose and at the same price as lower doses. Check the drug maker s web site to find out the various strengths your medication comes in, says Wertheimer. If you need 10 mg a day, ask your doctor to prescribe 20 mg then split the pill in half. Note that some drugs should not be split, including time-release pills and capsules. Consult your doctor to find out if pill-splitting is possible with your particular medication.

Another option: Ask your doctor if you can take your medicine every other day instead of everyday or once a day instead of three times a day, says Epperly. There are times when that s pharmacologically OK, especially if patients are trying to stretch their budget, he says.