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There was a time when almost everyone paid out of pocket for their prescription medications. Insurance companies did not pay for drugs. Neither did the federal government through Medicare or Medicaid. Paying cash for your prescription was considered normal. In those days, however, the cost of most medicines was affordable. Nowadays, brand name drugs are often unaffordable!
How Much Did Drugs Cost?
OK, I admit it. I am old! When I wrote the very first edition of the book, The People’s Pharmacy, I included a “Guide to Chain Store Prices.” The book was published by St. Martin’s Press in 1976.
Here are some examples of BRAND Name Prices from that time:
Achromycin V (tetracycline) 50 pills for $3.05
Inderal (propranol) 50 pills for $3.08
Ortho-Novum (norethindrone, mestranol) 21 for $2.09
Ovral (norgestrol, ethinyl estradiol) 24 for $2.19
Premarin (conjugated estrogens) 50 pills for $3.65
Ritalin (methylphenidate) 50 pills for $5.28
Synthroid (levothyroxine) 50 pills for $2.08
Valium (diazepam) 50 pills for $4.70
Those prices were for brand name medications.
Guess how much it would cost you to buy 30 pills of brand name Valium (5 mg) today? According to GoodRx, the retail price is between $235 and $285 in chain store pharmacies. By the way, Valium lost its patent a long time ago.
Why Would Paying Cash for Your Prescription Save You Money?
We recently received this message about paying cash for your prescription from a reader of our syndicated newspaper column:
Q. I think the electronic system that requires doctors to send prescriptions directly to the pharmacy makes it hard to control drug costs. I now insist that my doctors give me paper scripts.
I have Part D Medicare drug coverage. The cost for two drugs from a major chain drugstore using this insurance was far in excess of the cost at a local pharmacy with no insurance.
For example, my dermatologist prescribed an ointment for athlete’s foot. An 80-oz tube at the chain drugstore with my insurance was $110.00. The cost at the pharmacy in my local supermarket with no insurance was $15.00.
Also, my cardiologist prescribed tadalafil (Cialis) 5 mg for my high blood pressure. A three-month supply at the chain with my insurance was $330.00. The cost in my local pharmacy with no insurance was $45.00. People should be aware they can save money by shopping around, but you can’t shop with electronic prescriptions.
A. You have discovered a fascinating anomaly in the way that drug pricing works. Insurance companies often require patients to pay high out-of-pocket copay drug charges until they meet their deductible. It always makes sense to ask what the price would be without insurance.
Companies like GoodRx offer coupons that can also save consumers money if they don’t use insurance. This applies mostly to generic drugs. (We do not have any relationship with GoodRx and we take no money from this organization!).
Tadalafil is prescribed for both erectile dysfunction and pulmonary arterial hypertension. Although it is not an ordinary hypertension medicine, it can dilate blood vessels. This often results in lower blood pressure. The price for brand name Cialis could exceed $1,000 for a three-months supply. Your $45 cash price (presumably for the generic) is impressive.
Another reader paid $150 for a 90-day supply of the cholesterol drug rosuvastatin using his insurance. With a GoodRx coupon the cost would have been around $25 at some pharmacies.
Saving Money By Paying Cash For Your Prescription from Canada:
The two examples from our reader presumably involved generic drugs. Many of the people who have commented on this website have lost confidence in the FDA’s ability to guarantee the quality of these inexpensive medications. We have discussed the problems with generic drugs at length in many articles:
Generic Drug Failures Can Be Life Threatening
A Generic Drug Scandal That Amazed Even Us!
Can You Trust Generic Drug Quality?
Some people find that they have to buy a brand name medication to ensure they are getting exactly what their physician has ordered. But the cost of brand name medications in the US is totally out of control. That includes medications that have lost their patients. Brand name drug companies do not seem to follow the usual rules of capitalism in that they rarely lower their prices when there is generic competition.
Take the antidepressant Wellbutrin XL 150 mg. According to GoodRx, this brand name antidepressant could cost from $1,984 to $2,119 retail in a U.S. pharmacy for a one-month’s supply. At GoodRx the retail cost for the generic drug would be anywhere from $29 to $112 and the coupon cost would be from $11.96 to $20.69. The problem with generic bupropion, though, is that we have heard from many readers that some products smell bad. Read about this problem at this link. When bupropion has an unpleasant odor, it suggests chemical breakdown.
If people go to an official online Canadian pharmacy, the cost of brand name Wellbutrin XL 150 would be anywhere from $54 to $94 for a three month’s supply. Remember, that is the brand name price, not the generic bupropion price as listed on www.PharmacyChecker.com.
Many of these Canadian pharmacies have arrangements with pharmacies in Australia, New Zealand, the United Kingdom and India, which is why the prices are so low. If you prefer a Canadian pharmacy that ships from Canada, the price for 90 tablets of brand name WellbutrinXL would be $109.70 with a $9.95 shipping fee. That is almost assuredly if you are paying cash for your prescription.
In the United States, the retail price for the same brand name Wellbutrin XL 150 for a 90-day supply would be between $5,700 and $6,600 according to GoodRx. It is entirely possible that your insurance company would not pay for the brand name.
Learning More About How To Save Money By Paying Cash for Your Prescription:
We interviewed a favorite guest on the People’s Pharmacy radio show about Saving Money on Prescription Medications (Show 1308). Lisa Gill is a Health & Medicine Investigative Reporter at Consumer Reports. She has written extensively about this topic. You can listen to our interview at this link. Stream the audio recording by clicking on the white arrow inside the green circle under Lisa’s photograph.
You can also learn much more about this topic by consulting our eGuide to Saving Money on Medicines. It can found under the Health eGuides tab.
If you have been able to save money by paying cash for your prescription, please share your experience in the comment section below. If that has not been successful for you, please tell your story too.
Bill
I am fed up with Part D prescription drug plans, which I have been enrolled in for the past six years. I look on the Medicare compare site and see what they say a drug costs with my plan. I go to the plan website and see what they state. I get a coupon from GoodRx. None of those prices corresponds to what the pharmacy quotes, which is usually higher, often much higher. For example, I got a script for oflaxacin from my ophthalmologist. My insurance said it would be $16.95 at Safeway but Safeway said $50.90 with my insurance and $94.64 with GoodRx. GoodRx said the generic would be $18.21 at Walmart but Walmart said $42.44. With insurance, at Safeway the generic was $126.92! My dermatologist prescribed metronidazole cream. The cost varies from $15.49 to $313.53 depending on the plan used. According to GoodRx the retail price at Costco is $39 cash or $206 with insurance! This is crazy. Quotes for triamcinolone cream varied from $2.67 to $175.80. Fortunately, I take very few drugs. Comparison shopping is so time-consuming and makes me dizzy. A clerk at Fred Meyer recently put me on to SingleCare, which offers the best prices yet. Why is getting a fair price on prescription drugs more difficult than buying a car?
Melissa
I needed a script filled, but it had already been filled elsewhere, and I did not have time to get to that location. Insurance wouldn’t approve it, so I asked them not to use insurance, and I would pay out of pocket. With insurance it was $10, with cash it was $15, BUT insurance required that I get a 30 day supply as opposed to the 90 day supply the Doctor had prescribed.
Paying cash effectively cut my cost in half and gave me the convenience of refilling quarterly instead of monthly.
Carey
I started a job that I’d been doing as a temp. I was supposed to be covered by insurance by day 1, but I did not have any proof of insurance for the first month. I had cancelled my previous insurance with a very high premium.
I purchased 2 prescriptions during that time that would have cost, combined, $65 with the old insurance and $35 with the new. The cost was $500!
Although I eventually did, it took me months to figure out how to get reimbursed.
John
My Part D drug coverage is generally good, but I found that the price for 1 generic medication (Calciotrol) is much higher than other generics I take. Then I found the same generic medicine at Cost Plus Drug Company, Mark Cuban’s company is intended to lower the price for many generics). I don’t have the exact figures handy, but the copay under my Part D plan was about $60 for a 3 month supply, versus $20.00 at Cost Plus for a SIX months supply.
It takes a little effort to set up an account and enter the first order (everything is only online, as far as I can tell), but delivery worked well and I am now saving money.
Linda
A year or two ago my husband’s dermatologist prescribed a topical treatment for actinic keratosis. When he went to pick it up the price was almost $300 with Medicare Part D insurance. I’m not sure if the Rx was electronic or paper, but he had not yet paid. He balked and presented an AARP discount card similar to GoodRx (which we have found some pharmacies do not accept). The pharmacist said they did not participate in the AARP program but since my husband had that card the pharmacist could use a different program/card for the cash discount. The price was about $20.
For next year our Part D plan (same one) has given us a discount card to use for drugs not covered by Medicare. Not sure I trust those prices either, so our plan is to present this card, AARP discount card, GoodRx card, and Part D card for any new prescription and ask which will get the best price.
Some years ago I filled an amoxicillin prescription with employer insurance that required a $10 copay for any prescription. The pharmacist told me if I paid out of pocket (no discount card) the cost would be $7, so that’s what I did.
In both cases we were able to make the change at the cash register, but with the current prevalence of electronic prescriptions and overloaded pharmacists, I am unsure if this would work without a paper prescription.
Erin
One other cost saving idea: get your prescription filled at Mark Cuban’s Cost Plus online pharmacy. When I went through insurance and their recommended pharmacy, I paid 386 dollars for a 3 month supply of the drugs I take as a transplant recipient – plus the cost of insurance.
Cost Plus charged $71 dollars for the same drugs. I switched immediately and stopped using my Part D coverage plan, which seems to be worthless.
Daniel
Good information. I think it would have been helpful to include several discount RX programs, not just GoodRX. Of note, I’ve found WellRX to be cheaper than GoodRX in almost every case. I found it after GoodRX was sued by the FTC over selling user information; that’s been settled with a fine if I’m not mistaken, but who knows how any of these services make their money.
Providing reliable alternatives would keep readers from having to search amongst all the trash sites online. Same would be true for finding reliable Canadian pharmacies… how can one tell the good from the bad?
Mary M
I signed up for the GoodRX app, but found they don’t list either the BP or Thyroid meds I need.
I wonder if the list is complete? Hmmm