1. Ask for the cash price by name

The cash or self-pay price is often not what you are quoted by default. Ask for it explicitly at each pharmacy, and ask whether a 90-day supply changes the per-month cost.

2. Compare more than one pharmacy

Pharmacies set their own cash prices, so the same prescription can cost different amounts a few blocks apart. Costco's pharmacy is open to non-members by law, which makes it a useful comparison point.

3. Ask whether a generic exists

Where an FDA-approved generic exists, it is therapeutically equivalent and usually cheaper. Your pharmacist can tell you whether one exists for Amitriptyline.

4. Check patient assistance programs

Many manufacturers run patient assistance programs, and nonprofits such as NeedyMeds and RxAssist maintain databases of them. Eligibility rules vary by program.

5. Consider mail order

Mail-order pharmacies carry lower overhead and publish their pricing. Cost Plus Drugs publishes the manufacturer cost it pays plus a fixed 15 percent markup, a $5 pharmacy fee and $5 shipping.