America’s longest war was not waged in the jungles of Vietnam, nor is it being fought today in the mountains and caves of Iraq and Afghanistan. The battle goes on in our overcrowded cities and bucolic suburbs between HMOs and Medicare and the profit-hungry pharmaceutical industry.

The victims are American families making wrenching choices between food to help keep them healthy and medicines to help keep them alive.

Doctors and patients today routinely discuss medicines not in terms of potential effectiveness, but based on how much they cost. Many drugs, while effective, are prohibitively expensive, and many people simply do without. Other patients ask doctors to prioritize medications or pare down the dosage to help lower the pharmacy bill. These are decisions patients – and doctors – shouldn’t face.

Target, Kmart and other pharmacies are attempting to deliver some relief.

With doctors’ permission, the store pharmacies are substituting the lower-cost generic drugs for brand-name medications, which usually are far more expensive. According to Medicare, generic drugs contain the same active ingredients as brand-name medicines and are as safe and reliable as the equivalents. Patients pay between $4 and $9 a prescription for a 30-day supply that used to cost them far more.

One pharmacist offered this example: Thirty pills of the brand-name anticholesterol drug Pravachol sell for $162. The generic version, called pravastatin, can be obtained at store pharmacies for $9 – a $153 savings on just one prescription.

The list of substitutes is lengthy and involves medicines for a variety of diseases and conditions, but not every medicine has a cheaper alternative. Some pharmacies are distributing lists for patients to discuss with their doctors. Patients also can search online at www.rxlist.com.

“The savings can be considerable,” said Michael Anderson, pharmacist with AARP Medicare Rx Plans.

Care, and often patience, must be exercised to find savings. And the list of generic equivalents is subject to change.

Making medicine affordable is critical to most families. It can mean the difference between living healthy lives and struggling to survive. At many pharmacies, reasonably priced generic drugs are just what the doctor ordered.