Health care is expensive, even for those with insurance. My treatment with the breast cancer drug Herceptin cost $5,000 every three weeks for 52 weeks. Insurance paid 80 percent; I was responsible for 20. That's $1,000 every three weeks. Not exactly affordable.

What many of us don't know is that we can play an active role in cutting our health care bills. We can shop around for everything, for example. Before filling a prescription, consider comparing prices offered at mail-order and online pharmacies with those of larger retailers. You may even find that mom and pop shops offer competitive rates since they can set their own pricing. Don't forget about generic drugs too. Ask your doctor if a generic version of your medication is just as good as a brand name drug. If so, go for the price break.

Did you know that lab work is more expensive if you get it at a hospital? Ask your doctor for other trustworthy locations and save a few bucks.

The New York Times recently profiled pay-for-performance and risk-sharing pricing arrangements for high-cost drugs, including cancer drugs.

For example, Johnson & Johnson has proposed that the NHS in Britain pay for the cancer drug Velcade, but only for people who benefit as evidenced by tumor shrinkage. Velcade can cost $48,000 per patient. According to industry analysts quoted in the article, such a pricing scheme would probably only work in countries where there are single-payer health systems.

According to Dr. Lee N. Newcomer, senior vice-president for oncology at UnitedHealthcare, such risk-sharing arrangments would be harder to manage in the U.S. Newcomer says, "There's no way we could ask for it and have any leverage." He explains that state regulations and market forces make it impossible for an insurer to refuse to pay for a drug that has been approved by the FDA.

Other drugs cited in the article as potential targets for risk sharing between the manufacturers are Avonex for multiple sclerosis and even statins.