By Tim Bonfield
The Cincinnati Enquirer

Pick one Medicare drug discount card and a month's supply of Vioxx will cost about $78.

Pick another, and the same bottle of anti-inflammatory pills will cost nearly $106.

Starting Monday, seniors can sign up for one of more than 40 discount cards to be offered in Greater Cincinnati as part of a Medicare reform bill passed by Congress last year.

On Thursday, price information for 16 discount cards began appearing on www.Medicare.gov. Information for 26 other cards was not available.

The prices posted so far clearly show that seniors will benefit from shopping around. A check of just three commonly prescribed drugs - Vioxx, Lipitor and Viagra - reveals that price differences between cards can range from 16 percent to 71 percent, depending on which drug seniors need and which card seniors use.

A month's supply of Viagra, an erectile dysfunction pill, can cost $270 to $461. A month's supply of Lipitor, a pill that controls lipid levels in the blood, can cost $67 to $78.

Seniors who want to calculate how the cards would affect their own medication bills will need to run a list of their drugs through a government Web site or ask a clerk at 1-800-MEDICARE to provide help over the phone.

The prices vary so widely because some cards have contracts with or are sponsored by certain drug makers and various pharmacy chains.

That means some drugs can be much cheaper on some cards than others. No single card is likely to be the best deal for every medication.

Meanwhile, consumer groups are warning seniors that the drug prices posted Thursday could change next week or next month. Yet once you pick a card, you can't switch cards until next year.

Medicare officials have predicted that as many as 7 million of the more than 40 million people enrolled in Medicare will sign up for a discount card. Many of the rest won't bother because they already get better drug coverage through insurance plans they've purchased on their own or get through a former employer.

The Medicare discount card program appears to offer the strongest help for low-income seniors, who may qualify for a $600 annual drug credit and won't have to pay enrollment fees that can cost up to $30 a year.

But no one knows how many seniors will apply for a card that will be replaced in 2006 by a different Medicare drug coverage plan.

For those interested in using the Medicare Web site, here's how it works:

Go to www.Medicare.gov. Click on the words "New Drug Price Comparison Information Available Now!"

The next page that appears will offer a choice between "Quick Search" and "Eligibility Questions."

By entering income and other information on the Eligibility Questions form, you can learn whether you qualify for the $600 drug credit or other support programs. Quick Search asks people to enter their Zip Code, a list of up to 25 drugs to check, how far you're willing to drive, and whether you want mail-order prices as well as retail pharmacy prices.

Search several drugs at once, and you'll get a single combined price charged by the various cards and how many pharmacies accept the card near your ZIP code. To see how the prices vary per drug, you need to search one drug at a time.

E-mail tbonfield@enquirer.com