The pricing of generic medications for uninsured patients is irrational and counter-intuitive.
Because of this, the uninsured patient can pay far too much for a generic drug.
One might expect that the price of a generic medication to be “low”, and to not vary much from pharmacy to pharmacy.
This is often not the case.
What inspired me to write this post is hearing from several different patients that they had paid exorbitant prices for their generic meds.
Consider lamotrigine, the generic name for Lamictal, which is increasingly admired for its ability to prevent depression in bipolar II patients.
A typical initial prescription for lamotrigine would be for 60 25 mg pills.
Without insurance, the estimated cash price would be (from the Goodrx website, accessed 5/16/15: https://www.goodrx.com/lamotrigine/price#/?distance=6&filter-location=&coords=&label=lamotrigine&form=tablet&strength=25mg&quantity=60.0&qty-custom=&language=&store-chain=
Rite Aid $127.
This is far too much to pay. How to pay less:
1. Go to the Goodrx website http://www.goodrx.com/ (It is unnecessary to sign in or register)
2. Enter the name of the drug you’re interested in.
3. At the lamotrigine page, enter your zip code (so you can see the pharmacies closest to you), the dosage of lamotrigine you’re interested in, and the number of pills you’d like to buy
4. In the example above, I’d enter 90403 (my office zipcode), lamotrigine 25 mg, quantity 60.
5. The cheapest price ($13.98) is from “membership warehouse, name cannot be shown” (presumably Costco).
6. There is no need to battle traffic in the Costco parking lot, however, because of these prices (which require printing the free coupon from the Goodrx website):
Walgreen’s $14.38 (a 90% savings over the cash price)
But note, even with the coupon
Rite Aid $107.33
7. If you prefer your small, neighborhood, independently owned pharmacy (as I do), Goodrx will allow you to print out a coupon which you can take to your pharmacy. For the lamotrigine example, the cost is
independent pharmacy: $13.20
Example 2: sertraline 50 mg # 30 (generic for Zoloft, a commonly prescribed selective serotonin reuptake inhibitor, useful for anxiety and irritability)
Cash price: GoodRx coupon price
Ralph’s $42 $7.02
Vons $24 $8.45
Rite Aid $55 $9.99
Walgreens $36 $10.58
CVS $31 $24.93
Independent pharmacy $9.89
Example 3: in the above examples, the supermarket pharmacies (Von’s, Ralph’s) are often less expensive than the retail pharmacies (Walgreen’s, Rite Aid, CVS).
But this is only the case for non-controlled substances. For certain controlled substances, the retail pharmacies are less expensive
Adderall XR 20 mg # 30, in its generic form:
Cash price: GoodRx coupon price
Rite Aid $200 $81.08
CVS $175 $102.12
Independent pharmacy $133-133.50
Go to the Costco website http://www.costco.com/Pharmacy/home-deliveryb?storeId=10301&catalogId=10701&langId=-1 (You do not have to be a Costco member to use the pharmacy, due to a California state law).
Notice that this website is less informative, because you cannot customize the results.
A second weakness of the Costco site is that it will not give pricing information on controlled substances, such as stimulants (commonly prescribed for ADHD) or benzodiazepines (sometimes prescribed, cautiously, for anxiety).
In our case, looking for 25 mg lamotrigine, we find only the orally disintegrating tab, not the tablet, in amounts of 30 ($10.27), 50 ($13.10), and 100 ($18.26). The price is roughly comparable to the Goodrx coupon price at Ralph’s, Pharmaca, Walgreen’s, and Von’s.