The latest updates on prescription drugs and ways to save from the GoodRx medical team

How Switching Meds Could Save You More Than $2000 Per Year

by Elizabeth Davis on March 28, 2013 at 10:00 am

When it comes to saving on your prescriptions, sometimes the way to get the best price isn’t as straightforward as simply using a coupon or switching to a generic.

Recently, I visited a doctor to try and figure out why I was having headaches. It took months, but eventually I was diagnosed with migraines; then, I had to work with my doctor to find the right medication to manage the migraines.

Like many Americans, I have health insurance, but even with insurance, the cost of my drugs was giving me a headache. A single prescription for Axert (used for stopping overnight headaches) costs $350 – $400 for a pack of 12 tablets—with insurance!  At the time, Maxalt hadn’t yet gone generic, so a pack of 18 tablets would cost me $500 – $600. Another medication, Frova, was about $330 for 9 tablets.

Fortunately, my doctor was willing to try sumatriptan (generic Imitrex), and it worked for me after stepping up the dose. Before rizatriptan (generic Maxalt) was approved at the end of 2012, sumatriptan was the only real generic triptan option for migraine. My insurance co-pay was $10 per fill ($15 with a GoodRx coupon if your insurance doesn’t cover it), instead of over $300.

As my fellow migraine sufferers know, you fill every month whether you need to or not, just in case. Switching meds saved me almost $3,500 over a year, even with my insurance.

At GoodRx, we’ve just created a helpful list of drugs that can potentially be swapped out for much cheaper alternatives—sometimes saving you 90 percent or more. You can find some comparisons across a few classes of drugs below, and browse hundreds more by condition on GoodRx. As always, check with your doctor to see if the other options are right for you:

Migraines (Triptans)

If you’re taking . . .

  • Frova – Cash Price: $330 for a package of 9 tablets

Consider instead:

Zomig and Zomig ZMT (zolmitriptan) are also due to go generic this year, which should give you another lower-priced generic to choose from.

High Cholesterol (Statins)

If you’re taking . . .

  • Crestor – Cash Price: $180 per month

Consider instead:

Switching from Crestor to simvastatin, your savings would be over $175 per month or $2100 per year.

High Blood Pressure (ARBs)

If you’re taking . . .

  • Benicar – Cash Price: $110 per month

Consider instead:

Switching from Benicar to losartan, your savings would be over $100 per month or $1200 per year.

There are some cases where the reverse is true as well—you could be taking one of several expensive brands in a group where there’s one clear cost-saving option. For example:

Overactive Bladder (Muscarinic Agonists)

If you’re taking . . .

  • Toviaz – Cash Price: $175 per month
  • Vesicare – Cash Price: $200 per month
  • Enablex – Cash Price: $180 per month

Consider instead:

  • oxybutynin (generic Ditropan) at under $5 per month, for a savings of up to $200 per month or $2400 yearly.

Insomnia (GABA Agonists)

If you’re taking . . .

  • Lunesta – Cash Price: $230 per month
  • Edluar – Cash Price: $210 per month
  • Ambien – Cash Price: $250 per month

Consider instead:

  • zolpidem (generic Ambien) at under $10 per month, for a savings of up to $240 per month or $2880 yearly.

Of course, cost isn’t the only factor. Looking at drugs in the same class that treat the same condition can be a great jumping off point for a discussion with your doctor. It can take some trial and error to choose the prescription that’s right for you, particularly when you’re starting a long-term medication. Factors like different side-effect profiles and regular- and extended-release options can make a big difference in how effective a particular drug is for you, and whether you remember to take it as prescribed.

Be aware that even when a group of drugs works in the same way to treat the same conditions, there are cases where they may not be able to be substituted for one another—but stay informed, open a dialogue with your doctor and pharmacist, and you may be able to save big while still getting the medications you need.

With more choices, you can find the right medication to make both you and your wallet happy.

Under my Um-brella . . . Ella . . . Ella. What is Ella?

by Dr. Sharon Orrange on March 26, 2013 at 5:00 pm

What is Ella?  The latest in emergency contraception:

Whoops! Emergency contraception (EC) can prevent pregnancy soon after unprotected intercourse, sexual assault, or failure or improper use of a birth control method. EC reduces the risk of pregnancy when used up to 120 hours (5 days) after unprotected intercourse.

Almost 50% of all pregnancies and more than 82% of teen pregnancies in the U.S. are unintended. Emergency contraception exists because it is estimated that 1.7 million unintended pregnancies could be prevented annually if emergency contraception were used.

The newest EC available is Ella (ulipristal acetate) which is a single pill, making it more convenient than some of the other EC options. Here is what you need to know about Ella and other “morning-after” options for emergency contraception:

Ella is as effective as Plan B (levonorgestrel) up to 72 hours after unprotected sex, yet more effective than levonorgestrel from 72 to 120 hours.

• A pregnancy test is not necessary before administering EC pills because the medicines will not harm an existing pregnancy.

Ella, Plan B, Next Choice, and Plan B One-Step are the options for EC.

Ella is a single-dose pill that is a progesterone-receptor modulator and it’s usually more expensive than Plan B.

• Men and women over the age of 17 can purchase Plan B, Next Choice and Plan B One-Step without a prescription, but Ella requires a prescription.

Ella and the other EC pills work best when used up to 120 hours (5 days) after unprotected intercourse but are more effective if used earlier.

• Nausea occurs in half of the women who take EC pills and vomiting in one fifth but this is lower after taking Ella.

• After using EC, you should have your menses within 3 days of the expected onset date so if you don’t, see a doctor or take a pregnancy test.

Dr O.

The two-tablet packages of generic levonorgestrel and Next Choice should each cost around $25 – $35. The brand name Plan B runs closer to $40. Ella is slightly higher, closer to $45 at most pharmacies, though the manufacturer does offer it for $40 with an online prescription. Some insurance plans will cover some EC options, but may require a prescription even for the over-the-counter meds.

New Drug Images and Patient Info on GoodRx

by Elizabeth Davis on March 22, 2013 at 10:27 am

You can now find helpful information and images for all of your prescriptions on GoodRx! Look for new drug images and info tabs on our price pages to help you stay informed about the medicines you’re taking.

Not everyone keeps track of those pamphlets that come with your prescriptions, but there can be some useful information there. Now you can look up potential side effects, food and drug interactions, usage instructions, and more, all on the same page where you find your local prices. Just go to the “What is . . ” and “Side Effects” sections near the top of each search results page to browse.

In any case where we have current information or news about a drug—a blog post, a new or upcoming generic, a recall, or another update—you can find links to those articles posted under “Latest News.”

For most drugs on GoodRx, you can also now search by image to find prices for your exact prescription. On any results page, either click the image next to the drug name or go to the “Identification” section. You can sort by brand or generic, form, dose, shape, or color, or just browse all of the images to find the pill or package you’re using.

Try it out and let us know what you think!

Why Is My Celebrex So Expensive?

by Dr. Sharon Orrange on March 21, 2013 at 3:13 pm

Hundreds of dollars a month. This is what many are still paying for Celebrex. Why is that? Celebrex (celecoxib) has been the answer for pain from osteoarthritis, rheumatoid arthritis, headache and tooth pain for many people, especially in those who get stomach irritation from regular ibuprofen. Celebrex costs a ton because it’s a brand name drug and not available as a generic until 2014. The cost of Celebrex is even higher because your insurance company wants you to use the generic drug in the same class as Celebrex called meloxicam (Mobic is the brand name). Meloxicam is 5 bucks a month, Celebrex about 200 bucks.

What is so special about these medications? Celebrex and meloxicam are similar to other NSAIDs (ibuprofen, Motrin, Naprosyn) but instead of inhibiting both cyclooxygenase enzymes, COX-1 and COX-2, they are more specific inhibitors of COX-2. So the name of this particular class of NSAIDs is COX-2 inhibitors. You care about this because this means they cause less stomach irritation and risk of GI bleeding as compared to other NSAIDs.

Ok, less risk of GI bleeding—but does Celebrex work?

Yes it does. Celebrex works as well as other NSAIDs for gouty pain, rheumatoid arthritis, osteoarthritis and painful menstrual cycles, just for a few examples. So does meloxicam, a COX-2 inhibitor like Celebrex, and meloxicam is much cheaper.

COX-2 inhibitors gained fame when both Bextra and Vioxx were pulled from the market over evidence of increased risk of heart attack and stroke. Celebrex and meloxicam survived this scandal but remember this: the protective effect on the heart of aspirin, for example, is not shared by COX-2 inhibitors like Celecoxib as they don’t inhibit platelet aggregation.

If you are paying an arm and a leg for your Celebrex ask your doctor about trying meloxicam and if that doesn’t work for you, then maybe Celebrex is worth the cost.

Dr O.

Celebrex can cost $100 – $500 per month for cash-paying patients, depending on dose and frequency. It is considered a Tier 2 or 3 drug by most insurance plans that cover it, meaning a high copay as well. In contrast, meloxicam is available as part of some pharmacy discount programs for under $5 per month, and can be found at many pharmacies for under $5 – $10. Meloxicam is typically considered a Tier 1 generic by insurance companies, meaning you’ll pay only your lowest copay.

Gotta Go, Gotta Go: Here Comes the First and Only Over-the-Counter Patch for Women with Overactive Bladder

by Dr. Sharon Orrange on March 19, 2013 at 2:04 pm

Get ready. In July 2013 the first over-the-counter patch will be available for the treatment of overactive bladder in women. Overactive bladder (OAB) is a common condition that causes a frequent, sudden, unstoppable need to urinate. Women call this the “gotta go, gotta go” problem. These bladder issues sadly force people to limit their participation in physical and social activities (sitting through movies or plays, long car drives, etc.). Well, you will now have access to a patch you can buy and try that is over the counter. This obviously makes treatment more accessible and I hope cheaper.

Oxybutynin (Ditropan, Ditropan XL) is available now as a pill by prescription only. Oxytrol is the same medication, currently available as a prescription patch, which will soon be sold over the counter. That’s all good. With Oxytrol, since the drug is delivered into your bloodstream through your skin, it bypasses the liver and the stomach, limiting potential downsides. Dry mouth is the main complaint with Oxytrol and occurs less often than is seen with the Ditropan pill.

When Oxytrol for Women arrives in July 2013 it will be a thin, flexible, and clear patch applied to the abdomen, hip or buttock twice weekly that can be worn during normal activities, including bathing, swimming, showering, or exercising.

What about men? Oxytrol will remain available for men with OAB by prescription only. Hmmmm, what? The safety and effectiveness for over the counter use was only tested in 5000 women, and I imagine testing in men is underway.

Stay tuned.

Dr O.

Generic oxybutynin is currently the lowest cost option for the treatment of OAB, and will likely continue to be more affordable even after Oxytrol is released for sale over the counter. However, it does require a prescription where Oxytrol for women will not. Oxybutynin is available through many pharmacy discount programs for under $5 per month, and is considered a Tier 1 generic by most insurance plans, meaning you’ll pay only your lowest copay. In contrast, a one-month supply of Oxytrol (8 patches) can cost $250 – $300 out of pocket, and if covered, Oxytrol is considered a high copay Tier 2 or 3 drug by many insurance companies. The cost should decrease when Oxytrol makes the switch to over-the-counter—but it is still likely to be quite a bit higher than oxybutynin.

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