How to Pay Less for 13 OTC Products With a Prescription

Heading to the pharmacy window for a product that’s available over the counter (OTC) may seem counterintuitive. But doing so — whether or not you have insurance — may cost you less. 

Prescription medications that have switched to OTC are often still available with a prescription. And the prescription version may be more affordable in some cases. It’s also possible that you can get deeper discounts by using GoodRx coupon or your insurance.

What are the differences between OTC and prescription medications?

Differences exist between prescription medications and OTC medications, including:

• Access: With a prescription medication, your healthcare professional sends the prescription to a pharmacy, where a licensed pharmacist dispenses the medication. With an OTC medication, you can buy the medication off retail store shelves or online. There are some OTC products, such as cold or allergy medications that contain pseudoephedrine, that must be purchased at the pharmacy because they contain ingredients that can be used to make illegal drugs. These are known as behind-the-counter products.

• Cost: When comparing costs, don’t forget to add the expense of a healthcare visit to acquire a prescription into the total price of a medication. Prescription medications generally cost more than OTC medications, but not always. Costs vary widely depending on the product and insurance coverage.

• Labeling: OTC medications must feature consumer-friendly labeling that’s easy to understand. Prescription medication labels are often required to include more information, as well as specific dosage instructions.

• Potency: Prescription medications are typically more powerful than OTC medications.

• Safety: OTC medications usually have wider safety margins than prescription medications.

• Use: Sometimes, the OTC version of a medication treats different symptoms than the prescription version. For instance, prescription-strength meclizine is FDA approved for vertigo, while the OTC version only treats motion sickness.  

How can you save on OTC medications with a prescription?

Here are some ways you may be able to pay less for OTC medications and other products with a prescription:

• A prescription medication may cost less than the OTC version if you have a health insurance plan that has low prescription copays or coinsurance. For example, your plan may have a $0 or less-than-$10 copay for generic medications such as prescription-strength ibuprofen (Advil, Motrin). 

• Many prescription medication plans have an out-of-pocket maximum, after which you have no more cost-sharing for covered medications for the year. If you reach that threshold, then filling the prescription version of an OTC medication will likely cost you nothing extra.

• Ask your healthcare professional to write you a prescription for a 90-day supply of your medication, instead of a 30-day supply, to compare costs. Filling a 3-month prescription instead of buying a 3-month supply of OTC medication may lower your overall costs and be more convenient. If you have insurance, you also may be able to find savings, including free delivery, through your plan’s mail-order pharmacy.

• Having a prescription can help you access GoodRx coupon savings. With a GoodRx coupon, you may be able to pay a lower price for your medication.

• Unlike with OTC products, your payments for covered prescription medications count toward meeting your annual deductible and your out-of-pocket maximum, if you have insurance.

• You don’t have to pay sales tax on prescription medication in any state except Illinois. 

States without an OTC medication sales tax

Washington, D.C., and at least 10 states also exempt OTC medications sold without a prescription from sales tax. That means you don’t have to pay sales tax on OTC medications in:

• Florida

• Connecticut

• Maryland

• Minnesota

• New Jersey

• New York

• Pennsylvania

• Texas

• Vermont

• Virginia

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• Differences between prescription and over-the-counter (OTC) products: Learn about the differences between OTC medications and those that require a prescription from your healthcare professional.

• Sometimes, prescription-strength medications become available on the shelf. A process called the Rx-to-OTC switch transitions some medications from prescription-only to over the counter.

• Behind-the-counter medications: Some medications are kept behind the pharmacy counter and don’t require a prescription, but they typically have restrictions on who can access them.

13 OTC product types that may cost less with a prescription

You can often access an OTC product by prescription at a lower cost. And prescription products may come in higher strengths or doses and different dosage forms.

Here are 13 categories of products available by prescription and as OTC products: 

1. Acne medications: Some topical acne medications, such as the retinoid adapalene (Differin Gel), are available in more potent formulas with a prescription.

2. Allergy medications: You can choose OTC medications and nasal sprays to treat allergies, but more severe symptoms may require prescription options, like oral antihistamines, eye drops, and nasal sprays such as Dymista and Ryaltris.

3. Antidiarrheals: OTC versions of medications that treat diarrhea, such as loperamide (Imodium A-D), may be available at a lower price with a prescription.

4. Cold sore medications: There are OTC medications that can help manage cold sores. Those treatments and higher-strength options are available by prescription.

5. Cough relief medications: Cough medications that are available on pharmacy shelves often have similar prescription formulations.

6. Decongestants: If you have a stuffy nose and are looking for a medication containing pseudoephedrine, you’ll have to go to the pharmacy window anyway. Before getting the OTC version, find out if you can save with a prescription.

7. Heartburn relief medications: Many off-the-shelf heartburn medications, including omeprazole OTC (Prilosec OTC), are available by prescription.

8. Laxatives: Medications that treat constipation may be less costly with a prescription.

9. Oral contraceptives: On top of having more choices, you may be able to save money if you get a prescription oral contraceptive. Opill is the only OTC birth control pill available and typically costs $15 to $20 a month. If you have insurance, prescription birth control typically has no cost-sharing.

10. Pain relievers: Prescription-strength acetaminophen (Tylenol), ibuprofen, and other pain relievers come in higher doses than OTC versions. Lidocaine patches at OTC doses or higher are available by prescription.

11. Smoking cessation medications: If you get prescription nicotine therapy patches, insurance may cover the cost.

12. Urinary tract infection (UTI) pain medications: Accessing lower-dose phenazopyridine (Pyridium) with a prescription, instead of off the pharmacy shelf, may save you money.

13. Vitamins and supplements: You can often get iron supplements and prenatal vitamins by prescription at a lower cost than OTC versions.

Besides cost, why should you choose prescription medications over OTC medications?

Getting prescription versions of OTC medications can be beneficial beyond saving you money. You might opt for prescription medications for these reasons:

• Dose or potency: You need a higher dose or a higher-strength version of a medication.

• Delivery method: You need a certain dosage form, such as a suppository or powder, that’s only available by prescription.

• Instructions: You want someone to explain how or when to take a medication to help you get the most out of it.

• Safety: You want your prescriber and pharmacist to help you prevent interactions with other medications or foods and manage side effects. 

• Convenience: You live in a rural area or somewhere pharmacies are hard to access and you can save time and money by using a mail-order pharmacy. 

Why do some medications change from OTC to prescription?

The Rx-to-OTC switch is typically requested by a manufacturer who wants to market a prescription medication as available without a prescription. However, anyone can submit a petition to the FDA to switch a product from prescription to OTC.

Typically, only a few medications switch from OTC to prescription annually, and some years there aren’t any. Medications make an Rx-to-OTC switch in two different ways:

1. Full switch: This means the prescription and the OTC products have the same approved uses.

2. Partial switch: This means the uses for the medications can be different, with some uses requiring a prescription and others not.

What are the benefits of OTC vs. prescription medications?

OTC medications are popular for many reasons. Below are some of the benefits of medications available without a prescription.

Cost effective 

In a 2023 KFF survey, 31% of respondents said they did not take medication as prescribed because of cost, and 21% reported not filling a prescription because of cost. Some respondents opted for OTC options with lower prices instead.

Easy to understand and use

OTC medication labeling applies to more than 100,000 products. The labeling must be easy for the average consumer to understand and include: 

• A list of active ingredients contained in the product and what each of them do

• Information about who shouldn’t take the medication 

• Information about when and how often to take the medication

• Safety warnings, such as about side effects

FSA and HSA eligible

Like with prescription medications, you can use your flexible savings account (FSA) or health savings account (HSA) to pay for OTC medications, including allergy treatments.

Separate Medicare Advantage OTC benefits

Some Medicare Advantage plans also offer OTC benefits. These plans typically give you a debit card to purchase OTC medications, personal care products, and other qualified items.

Generally safe

OTC medications are approved because of the wide safety profile of their active ingredients. And their benefits outweigh their risks. 

Widely available and accessible

You can only pick up a prescription medication when the pharmacy is open and a licensed pharmacist is working. But you can grab OTC medications at any time at retail locations or online.

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Written by:

Lora Shinn, MLIS

Lora Shinn is a freelance writer with more than a decade of experience writing about health and personal finance, and has written for outlets such as Prevention, Healthline, The Paper Gown, and The Balance. Topics covered have ranged from medical clowning to creating a healthier home.

Edited by:

Cindy George, MPH

Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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