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Save Money by Paying Cash for Your Prescription

People assume that health insurance solves the problem of high drug costs. Not always! Sometimes paying cash for your prescription saves $$$.

There was a time when almost everyone paid out of pocket for their prescription medications. Insurance companies did not pay for drugs. Neither did the federal government through Medicare or Medicaid. Paying cash for your prescription was considered normal. In those days, however, the cost of most medicines was affordable. Nowadays, brand name drugs are often unaffordable!

How Much Did Drugs Cost?

OK, I admit it. I am old! When I wrote the very first edition of the book, The People’s Pharmacy, I included a “Guide to Chain Store Prices.” The book was published by St. Martin’s Press in 1976.

Here are some examples of BRAND Name Prices from that time:

Achromycin V (tetracycline)                           50 pills for $3.05
Inderal (propranol)                                            50 pills for $3.08
Ortho-Novum (norethindrone, mestranol) 21           for $2.09
Ovral (norgestrol, ethinyl estradiol)               24           for $2.19
Premarin (conjugated estrogens)                   50 pills for $3.65
Ritalin (methylphenidate)                                 50 pills for $5.28
Synthroid (levothyroxine)                                50 pills for $2.08
Valium (diazepam)                                             50 pills for $4.70

Those prices were for brand name medications.

Guess how much it would cost you to buy 30 pills of brand name Valium (5 mg) today? According to GoodRx, the retail price is between $235 and $285 in chain store pharmacies. By the way, Valium lost its patent a long time ago.

Why Would Paying Cash for Your Prescription Save You Money?

We recently received this message about paying cash for your prescription from a reader of our syndicated newspaper column:

Q. I think the electronic system that requires doctors to send prescriptions directly to the pharmacy makes it hard to control drug costs. I now insist that my doctors give me paper scripts.

I have Part D Medicare drug coverage. The cost for two drugs from a major chain drugstore using this insurance was far in excess of the cost at a local pharmacy with no insurance.

For example, my dermatologist prescribed an ointment for athlete’s foot. An 80-oz tube at the chain drugstore with my insurance was $110.00. The cost at the pharmacy in my local supermarket with no insurance was $15.00.

Also, my cardiologist prescribed tadalafil (Cialis) 5 mg for my high blood pressure. A three-month supply at the chain with my insurance was $330.00. The cost in my local pharmacy with no insurance was $45.00. People should be aware they can save money by shopping around, but you can’t shop with electronic prescriptions.

A. You have discovered a fascinating anomaly in the way that drug pricing works. Insurance companies often require patients to pay high out-of-pocket copay drug charges until they meet their deductible. It always makes sense to ask what the price would be without insurance.

Companies like GoodRx offer coupons that can also save consumers money if they don’t use insurance. This applies mostly to generic drugs. (We do not have any relationship with GoodRx and we take no money from this organization!).

Tadalafil is prescribed for both erectile dysfunction and pulmonary arterial hypertension. Although it is not an ordinary hypertension medicine, it can dilate blood vessels. This often results in lower blood pressure. The price for brand name Cialis could exceed $1,000 for a three-months supply. Your $45 cash price (presumably for the generic) is impressive.

Another reader paid $150 for a 90-day supply of the cholesterol drug rosuvastatin using his insurance. With a GoodRx coupon the cost would have been around $25 at some pharmacies.

Saving Money By Paying Cash For Your Prescription from Canada:

The two examples from our reader presumably involved generic drugs. Many of the people who have commented on this website have lost confidence in the FDA’s ability to guarantee the quality of these inexpensive medications. We have discussed the problems with generic drugs at length in many articles:

Generic Drug Failures Can Be Life Threatening

A Generic Drug Scandal That Amazed Even Us!

Can You Trust Generic Drug Quality?

Some people find that they have to buy a brand name medication to ensure they are getting exactly what their physician has ordered. But the cost of brand name medications in the US is totally out of control. That includes medications that have lost their patients. Brand name drug companies do not seem to follow the usual rules of capitalism in that they rarely lower their prices when there is generic competition.

Take the antidepressant Wellbutrin XL 150 mg. According to GoodRx, this brand name antidepressant could cost from $1,984 to $2,119 retail in a U.S. pharmacy for a one-month’s supply. At GoodRx the retail cost for the generic drug would be anywhere from $29 to $112 and the coupon cost would be from $11.96 to $20.69. The problem with generic bupropion, though, is that we have heard from many readers that some products smell bad. Read about this problem at this link. When bupropion has an unpleasant odor, it suggests chemical breakdown.

If people go to an official online Canadian pharmacy, the cost of brand name Wellbutrin XL 150 would be anywhere from $54 to $94 for a three month’s supply. Remember, that is the brand name price, not the generic bupropion price as listed on www.PharmacyChecker.com.

Many of these Canadian pharmacies have arrangements with pharmacies in Australia, New Zealand, the United Kingdom and India, which is why the prices are so low. If you prefer a Canadian pharmacy that ships from Canada, the price for 90 tablets of brand name WellbutrinXL would be $109.70 with a $9.95 shipping fee. That is almost assuredly if you are paying cash for your prescription.

In the United States, the retail price for the same brand name Wellbutrin XL 150 for a 90-day supply would be between $5,700 and $6,600 according to GoodRx. It is entirely possible that your insurance company would not pay for the brand name.

Learning More About How To Save Money By Paying Cash for Your Prescription:

We interviewed a favorite guest on the People’s Pharmacy radio show about Saving Money on Prescription Medications (Show 1308). Lisa Gill is a Health & Medicine Investigative Reporter at Consumer Reports. She has written extensively about this topic. You can listen to our interview at this link. Stream the audio recording by clicking on the white arrow inside the green circle under Lisa’s photograph.

You can also learn much more about this topic by consulting our eGuide to Saving Money on Medicines. It can found  under the Health eGuides tab.

If you have been able to save money by paying cash for your prescription, please share your experience in the comment section below. If that has not been successful for you, please tell your story too.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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