The Top 10 Most Expensive Popular Generic Drugs in the US (and How to Save)
People often turn to generic medications for cheaper alternatives to brand-name drugs. But over the past couple of years, prices for generics have increased substantially, and some of the most expensive generic medications now run above $500 for a month’s supply. Every year, people are paying more for them despite insurance coverage due to high deductibles and changes to formularies (a list of drugs an insurance plan will cover).
We’ve reported on the most expensive prescription drugs available in the U.S., where we see prices reaching over $80,000 per month. However, these medications generally treat rare conditions. For instance, Actimmune treats chronic granulomatous disease, which affects very few people in the U.S., and Myalept treats generalized lipodystrophy, which only affects 1 in 10 million people worldwide.
So, what are the most expensive medications that people commonly take?
To answer this question, GoodRx analyzed cash prices for the top 100 generic drugs based on a representative sample of U.S. prescription fills. Below are the top 10 most expensive. Reported prices are based on the cash price at the pharmacy — the so-called “usual and customary” price.
1) Tadalafil
Topping the list is tadalafil, with 30-day prices averaging $518. Tadalafil is the generic version of two different brand drugs: Cialis and Adcirca. Cialis is mainly used to treat erectile dysfunction, while Adcirca is prescribed for hypertension. The generic version of Cialis is the drug that tops our list due to its popularity, but the generic version of Adcirca (which only comes in the 20 mg measurement) comes at a steep cost, too.
Luckily, there are some ways to save. GoodRx coupons can help you save 96% off the cash price of tadalafil, so you can get it for as little as $12 per month. There may also be lower-cost alternatives in the same class as tadalafil.
2) Zolpidem
Second on the list is zolpidem, another drug that is a generic version of two brand drugs: Intermezzo and Ambien. Both brands are used to treat insomnia but come in different forms, a tablet and sublingual tablet. The average monthly cash price for zolpidem is $296.
Medicare and commercial insurance plans usually cover zolpidem, but if you don’t have coverage, you can save up to 76% off the cash price with a GoodRx coupon.
3) Diclofenac sodium
The next most expensive popular generic is diclofenac sodium. This drug is an nonsteroidal anti-inflammatory drug (NSAID) that is used to treat several conditions including eye inflammation, osteoarthritis, and rheumatoid arthritis. Diclofenac sodium comes in several different forms depending on what disease it’s being used to treat. The bottle of topical solution of diclofenac sodium has an average cash price of $277 a month.
There are multiple ways to save on diclofenac sodium. If you happen to be an individual using this treatment for gout, you might be able to get help from the HealthWell Foundation, with certain restrictions. You can also pay as little as $28 for diclofenac sodium with a GoodRx coupon.
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4) Estradiol
Coming up fourth on the list is estradiol, a form of estrogen that treats conditions like osteoporosis, menopause, and atrophic vaginitis. Estradiol comes in many different forms, but a tube of estradiol cream has an average monthly cash price of $252.
Most insurance and Medicare plans cover estradiol, but there are still ways to save for those that lack coverage. A GoodRx coupon for estradiol cream can bring the price down to $34.
5) Sildenafil
In the middle of the list, with 30-day prices averaging $248, is sildenafil. This medication is the generic version of two different drugs on the market — Revatio and Viagra. Similar to tadalafil, one of its brand counterparts, Revatio, is used to treat pulmonary arterial hypertension, while the other brand, Viagra, is prescribed for erectile dysfunction in men.
So, how can you save? There are multiple patient assistance programs available that can help low-income or uninsured individuals access their sildenafil for free. Read more about these savings programs here.
6) Celecoxib
Celecoxib is a popular medication primarily used to treat conditions including osteoarthritis, rheumatoid arthritis, and pain. A generic for the brand Celebrex, the average monthly cost for celecoxib is $210. This drug is often covered by insurance plans, but you can also get it through GoodRx for as little as $10. Celecoxib may also be covered for your condition through the HealthWell Foundation.
7) Valacyclovir
Valacyclovir is an antiviral medication used to treat or prevent infections like shingles or herpes. It is the generic for the brand drug Valtrex. The cash price for a 30-day supply of valacyclovir is $192. The good news is that there are always ways to save, like finding a cheaper alternative medication in the same drug class, or by using GoodRx. A GoodRx coupon for valacyclovir can bring the price down to as low as $17.
8) Amphetamine salt combo XR
The next drug on the list is amphetamine salt combo XR, or generic Adderall XR. This drug is used to treat attention-deficit hyperactivity disorder (ADHD) and has an average monthly cost of $190. Medicare and insurance plans will usually cover amphetamine salt combo XR, but you can save with a GoodRx coupon and bring the cost down to as low as $22. However, because this drug is a controlled substance, whether a coupon will be accepted or not is at the discretion of the pharmacist.
9) Paroxetine
The average monthly cost for paroxetine is $188 for a 30-day supply of capsules. There can be a big price difference depending on which form of paroxetine you get. The capsule form of paroxetine, which is the generic for Brisdelle, is used to help treat the side effects of menopause.
Most insurance plans cover paroxetine, so there’s a good chance you won’t be paying out of pocket. But if you are, there are ways to save. A GoodRx coupon may be able to get you a month’s supply of paroxetine for as little as $48.
10) Levetiracetam
Last but not least is levetiracetam, an anti-epileptic used to treat seizures. It is the generic for two different brand drugs: Keppra and Roweepra. The average monthly cost for this generic drug is $186, and thankfully insurance will cover it most of the time. If not, you can use a GoodRx coupon to get the oral solution of levetiracetam for as low as $10. You can also check out alternative options in the same drug class here.
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Methodology
This GoodRx analysis is based on a representative sample of U.S. prescription fills (not GoodRx fills) and comes from several sources, including pharmacies and insurers. The reported prices are based on average retail prices, the so-called “usual and customary” prices or retail prices at the pharmacy (not including insurance copays or coinsurance). All prices listed in this article are based on data from July 1, 2020, to June 30, 2021.
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References
HealthWell Foundation. (n.d.). AutoImmune - Medicare access.
HealthWell Foundation. (n.d.). Gout - Medicare access.
