Think drug cards will save you big bucks? Not likely.

A YouTube video depicts the following scene: A pharmacist brings a prescription to a woman holding a baby.

The woman looks at the bill and gasps. Even the baby looks shocked. An announcer exclaims, "How can she afford this?"

Then, in a burst of light from the heavens, a small piece of paper, called a "State Discount Card" and billed as the "best free prescription discount card in America," flies into her hand to save the day.

Dozens of such cards can be found online, promising fabulous discounts on prescription medicine for the click of a mouse. They're aimed at the growing ranks of uninsured or under-insured who need help paying for medicine that can easily top hundreds of dollars a month for a small family.

Are these cards panaceas for patients, or merely marketing nets for the companies that push them?

"Chances are you could find the same or even a better price without the card," said Lawrence Barlow, a pharmacist and owner of Irwin's Pharmacy in Chesapeake. "You could call several drug stores and find the best price, and I would say nine times out of 10 you'll get a better price than with a discount card."

Group Net LLC of Baton Rouge, La., markets the card highlighted in the YouTube video. Rex Bowden Jr., president of Group Net, says the cards his company produces are a "win-win-win" for patients, pharmacists and his company. Patients get discounts, the pharmacies get more customers - who may also buy other things - and his company gets paid when a card is used.

Essentially all the state drug cards, including the Virginia card - which has no affiliation with the state government - are the same as the Your Rx Card, which Group Net also generates. "They're just different brands," said Bowden, who added that the Your Rx Card has about 1.5 million members.

Various cards now on the Internet promise discounts as high as 80 percent, but others are careful not to promise too much.

FamilyWize Community Service Partnership, a national group based in Pennsylvania, offers a free card associated with the United Way. Dan Barnes, its co-chair, said the group deliberately avoids touting the rare high discount to avoid misleading people.

Consumers with the FamilyWize card will save an average of 20 percent on eight out of 10 prescriptions, he said. In about 20 percent of the cases, the shopper will find that the regular price at the pharmacy will be lower.

In The Pilot's head-to-head comparison of four prescription discount cards - two free and two that charged fees - on several best-selling drugs, all offered comparable prices.

Even with discount cards, brand-name medicines are still going to cost a lot more than generics. Chemically identical generic drugs "start off lower and the discount is higher" because pharmacies have a higher profit margin on them, Barnes said.

Take antidepressant Zoloft and the generic sertraline, for instance.

In a comparison of four cards, including FamilyWize, the discounted prices for 30 100-milligram tablets for Zoloft were about $100; sertraline cost between $10 and $20. Without drug cards, local drugstores report retail costs of Zoloft at just over $100 while sertraline cost more than $50. These are the prices uninsured customers would be charged.

Most sites promise to respect your privacy. Bowden said Group Net does not collect or sell information on the people who apply for cards, in part because they and the pharmacies could run afoul of federal medical privacy laws.

But some sites are awash in commercial links, and even a little personal information can open the door for marketing pitches, at the least. Some card sites are filled with links for more discount programs that are not free to join.

Cards affiliated with United Networks of America are an example. Another Baton Rouge-based health industry group, United Networks is the force behind a number of cards on the Web, including one ballyhooed in some media in April called the Virginia Drug Card.

To get the card, you give a name and an optional e-mail address. Within seconds, you're a "member" with your own ID number. There also several links to other "discount" health "plans" - including vision, dental and diabetic supplies, some of which require a membership fee to join. There are also links to for-hire credit counseling and tax-relief firms.

On the Web site's home page, there's an invitation for a "free" vision plan if you provide five of your friends' e-mail addresses. But you can go straight to the vision plan's Web site and get the free plan - which offers discounts on eyeglasses - without having to give your friends' addresses.

In general, prescription discount cards don't arouse any particular enthusiasm or ire among consumer groups.

"I've heard mixed messages. Some people say they're great, some people say they're worthless," said Shauna Hatfield, a senior case manager with the Patient Advocate Foundation, a national nonprofit based in Newport News that provides financial and other assistance to people trying to navigate the health care system.

Aside from prescription discount cards, there are ways to save on your medicine - and one of the first is to make your doctors aware of how finances fit into your health care equation.

"I advise patients to be upfront about your ability to afford medicine," said Constance Goodman, a nurse and patient services administrator at the foundation. She advises people to ask their doctors, "Is this expensive?" and, "Can we go with something that may be older but that is tried-and-true and just as effective?"

In 2006, Wal-Mart started a $4 prescription program for hundreds of generic drugs, and since then other retailers - such as Target, Kmart and Kroger - have followed suit. You can take the list of $4 drugs to your doctor and see if there's anything there that would work for your condition, Goodman said. Pharmacist Barlow said many pharmacies, including Irwin's, match lowest prices.

Other options include asking your doctor for free samples for more than just the first month and taking advantage of mail-order prescriptions.

Goodman said one of the barriers patients have to overcome is feeling needlessly ashamed if they can't afford medicine.

"Patients are not at all aware of how much this costs," Goodman said. "It's not like the price of gasoline. You don't have any concept of what happens until it happens to you."

Nancy Young, (757) 446-2947, nancy.young@pilotonline.com