The People's Perspective on Medicine

Be Wary of Stratospheric Increases in Generic Drug Prices

Generic medications are supposed to be a bargain. According to the FDA, patients may be able to save as much as 80 percent on some products.

Big box discount stores have enticed customers with a three-month supply for $10. There are certain pharmacies that have even gone so far as to give away some popular generics such as atorvastatin (Lipitor) to lower cholesterol.

The generic drug industry is changing, however, and consumer savings are slipping. In some cases, the rise in generic drug prices has been breathtaking.

Take the antibiotic doxycycline, for example. It was first approved under the brand name Vibramycin in 1967. This broad-spectrum tetracycline-type drug has been used for decades to treat a wide range of infections, from chlamydia and cholera to Lyme disease and Rocky Mountain Spotted Fever. Doctors also use it for urinary and respiratory tract infections.

Doxycycline used to be dirt cheap. One analysis from Pembroke Consulting found that the price of this antibiotic has gone from $.06 per pill to $3.65. That is an increase of over 6,000 percent in a relatively short period of time.

The same analysis found that clomipramine, a drug prescribed for obsessive-compulsive disorder, has gone up more than 3,000 percent from $0.27 per pill to $8.57.

Why have some generic drugs gone up so dramatically? Consolidation within the generic pharmaceutical industry means that fewer companies are making generic medications. Just three companies, Mylan, Teva and Actavis, generated 44 percent of generic drug revenue around the world.

Another serious problem is shortages. A number of companies have stopped making certain generic drugs. Lack of competition has led to decreased supply and increased demand, resulting in price gouging.

Several large generic drug makers have gotten into trouble with the FDA because of bad manufacturing practices. As a result, some key products from abroad have been banned, contributing to shortages and higher prices.

Pharmacies can also charge vastly different amounts for the same generic products. Consumer Reports surveyed 200 pharmacies around the country and found a wide spread in prices. Atorvastatin (Lipitor) ranged from $150 at CVS to $17 at Costco. Clopidogrel (Plavix) had a similar variation, from $15 at a discount drugstore to $180 at a large chain.

What should consumers do? It is becoming more difficult to do price comparisons online, but it is still important to shop comparatively. Call different pharmacies to get their prices. Sometimes bargaining will work, since many pharmacies are willing to match a competitor’s price.

Another place to get comparative price information is This website uses international pharmacies to find the best price for both generic and brand name drugs. We also offer guidelines and tips for using generic drugs wisely in our Guide to Saving Money on Medicine. 

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Was pricing Doxycycline today. Pretty much the low end rate cited by GoodRx in my area is in the $40+ range for 60 capsules.

The really annoying thing is that I can get the same medication from the online pharmacy, Allivet, for $1.05 for 250 capsules. The Allivet product, though being sold for animal use, is described as “Doxycycline capsules, USP” and the label prominently displays the NDC held by PAR showing the product in the bottle is registered by the FDA for sale for human use.

Graedon suggests the reason that human doxycycline has become so expensive is consolidation and shortages. The fact that human approved medicine is being sold dirt cheap for animal use suggests that this is not the case.

I know it may sound like I’m going conspiracy theory here, but I strongly suspect that Galderma, manufacturer of the uber expensive doxycycline preparation Oracea (a 40 mg dose preparation containing 30 mg of immediate release and 10 mg of delayed release) has been engaging in pay not to play with the generic tetracycline manufacturers. Not unlike the way the government pays farmers not to plant crops to prop up farm prices.

Oracea retails for $620 for 30 capsules. They have a patent on this mixed immediate/timed release preparation for rosacea until 2022. It’s no wonder they would want to keep cheap generic doxycycline (even if it is immediate release only) off of the market.

So, it’s a great deal. Humans pay $20+ for a 40 mg capsule. Pet owners pay less than a penny for a 100 mg capsule. Galderma makes incredible profits, and has plenty left to pay generic doxycycline producers not to produce.

Finally, I don’t have any proof that Galderma is paying generic manufacturers not to produce doxycycline, but it is well known that brand name manufacturers have a long history of paying generic manufacturers not to produce when patents run out.

You are totally right! I am a pharmacist and have recently left my field to find my true calling. I literally am sick of the shady dealings of pharmaceuticals, doctors, insurance, and pharmacies. It is an evil business and I don’t want to be a part of it. The mainstream are not affected but the vulnerable sick and poor are devastated. This doxycycline price increase is absurd and totally corrupted by Oracea. Before price increase and Oracea, Publix Pharmacy was selling doxycycline for free!

My mother was prescribed Nystatin and Triamcinolone Acetonide cream for occasional fungal skin infections. Prior to about 2010 it was about $11.00 for a 60mg tube. The following year it went up to $160 per tube. The year after that, $240 a tube. This year it is going for $360 a tube. Are you kidding me? No one seems to be able to answer what is going on, but I cannot believe the ingredients are so costly it warrants such a markup. I feel like we are turning into a third world country.

It has been my experience the big box drug stores will not give you a price until you give your insurance card. I think they should be able to check a price to avoid the customer sticker shock. Where else do you purchase something cost unknown?
They know once they have the prescription in hand we are going to go ahead and get it. I am retired from a very large Telco and have a $2500 rx deductible. I have called every drug store in my town and said I did not have insurance. It is amazing the difference in cost each drug store charges.
Most of the find I can get it cheaper not using my rx plan. Of course it doesn’t go toward deductible. I wish there were law to fix this.

I think the big insurance, pharma and drug companies have found a loop in the new laws and taking advantage and abuse the new changes which they should NOT do that (increase cost of meds etc). someone in the government in charge are not seeing these problems and poor solutions.

I’m flabbergasted. We are both on Medicare. We paid last year per month $26 for our drug plans. This year it’s $78 a month. We used to pay about $80 a month for all drugs…. now one of my husbands costs $88 a month. He had to stop taking one the went from a few bucks to six hundred. Right now we can’t afford our meds and our apartment and food. There must be some specific reason why things changed so drastically in 2014. I’d love to know why.

It’s simple; Europe caps drug prices to protect consumers and the US doesn’t, to protect corporations.

That’s how the amazing capitalism works. It has nothing to do with what something or worth, but how much can be made without thought or care to whom those profits cause harm.

The problem isn’t capitalism, but the bastardized form of it, promoted by the government in the U.S. True capitalism would allow free competition and would benefit consumers. The shady dealings of the pharmaceutical companies amounts to price fixing. That is not true capitalism in action, but is rather more akin to the of a crime syndicate.

I buy my amaryl pills 100 for €12 euros exactly the same than USA but much cheaper here (for what I see it costs from $90 to $48 depending where you buy them.) I don’t understand how can be that much difference in price from one country to another for the same medication.

Thanks to The People’s Pharmacy for seeking and telling the truth about high drug pries and drug safety issues!
To answer Pat’s question: The U.S. Food and Drug Administration has made it very clear that Americans are not prosecuted for importing small quantities of prescription medication for their own use. However, because medications in pharmacies outside the U.S. don’t have the official FDA stamp of approval, it is under most circumstances technically illegal for individuals to import them.
Gabriel Levitt
Vice President

Thank you for addressing this issue. Consumers have long been able to count on generic drug prices being cheaper. Reports of rising generic prices are especially troubling. Record numbers of Americans are already going without their needed medications due to the exorbitant cost of brand name prescription drugs in this country.
Drug importation from legitimate international online pharmacies can be a safe, affordable alternative. In fact, over a million Americans each year rely on this virtual lifeline to medicine. It’s important for consumers to take care when buying prescription drugs online. Independent verifiers such as, the Canadian International Pharmacy Association and Pharmacy Accreditation Services can assist consumers with finding legitimate Canadian and international online pharmacies. We also have tips for finding a safe online pharmacy on our website.
RxRights is a national coalition of individuals and organizations dedicated to promoting and protecting American consumer access to sources of safe, affordable prescription drugs. We also have testimonials on our website from Americans struggling to afford their medicine (and many who import) on our website.

I used the pharmacychecker and the pharmacies listed with the lowest priced were all Canadian. Is it legal to order drugs from Canada? None of my medications are narcotics.

It doesn’t make sense to me that a drug from the 60’s it became expensive when the pharma co. don’t have to do ‘any work’ These increases and excessive charges for new drugs should stop.

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