Patients often turn to generic medications for cheaper alternatives to brand-name drugs, but over the past couple years, prices for generics have increased substantially, and some of the most expensive generic medications run above $100 for a month’s supply. Every year, people are paying more for them despite insurance coverage due to high deductibles and formulary changes.
Last month, we reported on the most expensive drugs on the market today. Drugs like Daraprim and Harvoni topped the list, with prices reaching well over $25,000 per month. But these drugs generally treat rare conditions. For instance, Actimmune treats chronic granulomatous disease, which affects very few people in the United States, and Myalept treats generalized lipodystrophy, which only affects one in 10 million people worldwide.
So, what are the most expensive drugs that people actually take?
To answer this question, GoodRx analyzed cash prices for the top 100 generic drugs based on a representative sample of US prescription fills. Reported prices are based on the cash price at the pharmacy – the so-called “usual and customary” price. (They don’t include insurance co-payments or co-insurance payments.)
Here are the top 10 most expensive popular generic drugs in the US:
Topping the chart, with 30-day prices averaging $279, is sildenafil, the generic version of two different drugs on the market right now — Revatio and Viagra. Revatio is used to treat pulmonary arterial hypertension, and Viagra is prescribed for erectile dysfunction in men. Unfortunately, there is a big price difference depending on the strength of sildenafil you are filling. Sildenafil at 20 mg (the equivalent to Revatio) can be very affordable, while sildenafil at 100 mg (the equivalent to Viagra) is expensive with just one tablet averaging around $30.
So how can you save? There are multiple patient assistance programs available that can help low-income or uninsured patients access their sildenafil for free. Read more about these savings programs here.
Topping the chart, with 30-day prices reaching well beyond $180, is duloxetine (Cymbalta). Used to treat depression, anxiety, fibromyalgia, and nerve pain associated with diabetes, duloxetine is covered by most commercial insurance plans — about 95% in fact. But for those of you who might lack coverage for it, shelling out over $150 per month can be too much.
How can you save? GoodRx coupons can help you save up to 90% off the cash price, so you can get it for as little as $20 per month. It also helps to shop around — a similar generic, venlafaxine (Effexor), could be more affordable depending on your insurance.
Oseltamivir (Tamiflu) is an expensive flu medication — one course of the drug costs around $133. If taken within 48 hours of symptom onset, oseltamivir can shorten the duration of flu symptoms by 1.3 days. Oseltamivir is not usually covered by insurance plans, but when it is, it is still placed in higher tiers and you will likely be on the hook for a fairly high co-pay.
The flu doesn’t have to affect your wallet. GoodRx coupons can help you save as much as 92% on oseltamivir, and there are a couple of other medications that may be more affordable than oseltamivir. More on that here.
Omeprazole is used to treat acid reflux or GERD, and comes in over-the-counter (Prilosec) and prescription-strength forms. While prescription-strength omeprazole is covered by most commercial insurance plans, a one-month prescription can cost patients $132 without insurance.
So instead of shelling out over $100 per month, how can you save? First, a 30-day supply of omeprazole can cost as little as $10 with a GoodRx coupon. Second, if Prilosec isn’t working for you, instead of going with prescription-strength omeprazole, you might want to give esomeprazole (Nexium) a try. In fact, for some people, esomeprazole works better than omeprazole for GERD.
Used to treat high cholesterol and prevent the risk of heart attack or stroke, atorvastatin (Lipitor) is currently the most popular drug in America. It’s not surprising then that it’s covered by most insurers. Cash prices are still expensive though — even after prices declined by about 3% over the past five years, a monthly supply still costs around $121.
You can purchase atorvastatin for as little as $10 per month with a GoodRx coupon. And there are alternatives. Rosuvastatin (Crestor) is a newer statin medication than atorvastatin, but works similarly and is affordable; you can pay as little as $10 with a GoodRx coupon.
Clopidogrel (Plavix) is a popular antiplatelet drug, but it can break the bank. While it is covered by 97% of commercial insurance plans, the cash price for a 30-day supply is around $114. What’s more, patients are typically on clopidogrel for some time — up to 18 months in some cases.
Rather than spending over $100 at the pharmacy every month, shop around! A GoodRx coupon can reduce clopidogrel’s price to as little as $10 for a 30-day supply.
Montelukast (Singulair) is a popular medication used to prevent and treat asthma and allergies, but it’s pretty expensive — the cash price for a month’s supply is around $106. People tend to take montelukast for many years, so it’s fortunate that the drug is covered by many commercial insurance plans. However, if you need to pay out of pocket, try using a GoodRx coupon to get montelukast for as little as $12.
Another antidepressant, escitalopram (Lexapro), carries a cash price of $104 for a 30-day supply. While escitalopram is covered by most insurance plans, some plans have quantity limits and will only cover a certain amount of the drug every month. If you still can’t afford it, talk with your doctor about some alternatives that may be cost effective for you.
9) Bupropion XL
Bupropion XL is the generic version of Wellbutrin XL and is used to treat depression. It can cost as much as $102 for a 30-day supply. There is good news though: bupropion is covered by nearly 99% of plans, so there’s a good chance you won’t be paying out of pocket. But if you are, there are ways to save.
First off, a GoodRx coupon may be able to get you a month’s supply of bupropion XL for as little as $20. Also, there are a host of antidepressants on the market, some that are covered by your insurance or cost less out of pocket. You can read more about these alternatives here.
Last, but certainly not least, is tamsulosin (Flomax), a popular drug used to treat enlarged prostates in men. Tamsulosin is covered by most insurance plans, but out-of-pocket, it could cost around $86 for a 30-day supply.
If you are unable to afford tamsulosin, try a GoodRx coupon that can reduce your out-of-pocket cost to as little as $15. Additionally, some research has indicated that herbal therapies may be successful in helping men with an enlarged prostate. While the medical evidence is conflicting, they may be more affordable? Read more on that here.
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The above analysis is the first in a two-part series on expensive but widely used medications. In Part 2, we will look at the most expensive common brand-name medications in the US. Stay tuned!
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