It isn’t just high prescription prices in the U.S. that can be crazy-making — the variance in price from one pharmacy to another can defeat even the smartest consumer’s efforts to shop rationally. If you’re paying out of pocket for your scripts, either by necessity (because you’re uninsured) or choice (because you have a brand or dosage preference your plan won’t honor), finding the best price can be a real challenge.

Consider these examples from the comparison-shopping site (accurate as of July 4, 2020):

Generic Crestor, 40 mg, 30 tabs: $13 at King Soopers, $60 at Target, or $82 at Walgreens. It’s the same product. It’s as if a $3.39 gallon of milk at King Soopers cost $21 across the street.

How about generic Viagra, 100 mg, 30 tabs? That’ll be $15 at King Soopers, $34 at Walmart, $346 at Target, or a truly impressive $542 at Walgreens. That’s like paying $122.50 for that jug of milk.

Price differentials among brand-name drugs aren’t always as vast, but they are incomprehensible — even to pharmacists. We once asked a Walgreens pharmacist why he sold a bottle of a particular drug for $280 when a competing chain less than a mile away sold it for $80 and Costco had it for $16. He replied, “Well, Walgreens doesn’t compete on price.” We told him we were in complete agreement.

As if any more evidence of dysfunction were needed, the cash price of a drug can sometimes be lower than an insurance copay. That’s right: If you needed, say, a year’s worth of amlodipine 5 mg, a common blood pressure treatment, you would pay $120 less if you walked into King Soopers and kept your insurance card in your pocket.

Kudos to for offering consumers a fighting chance, but here are two more ideas to consider:

Seek out a compounding pharmacy 
On occasion, a custom-made drug can be considerably cheaper than the mass-produced version. Perhaps the most dramatic example is branded topical testosterone, which can cost as much as $650 a month at a retail pharmacy or as little as $50 at a compounding pharmacy.

As of this writing, the brand thyroid medicine Synthroid (100 micrograms, 30 tabs) is $43 at Walmart but the equivalent of US $10 from a Canadian pharmacy, to take just one example. Let’s be clear that ordering drugs from Canada is what you might call “technically illegal,” in the sense that there are laws prohibiting the importation of prescription drugs and if you did that, you’d be breaking those laws. But the practice has become so widespread, and is supported by so many U.S. lawmakers, that it’s also what you might call “practically legal.” The FDA website has a fact sheet about this that should put you at ease. Just do your research, because despite Canada’s reputation for honesty, there are fake Canadian pharmacies that exist solely to rob desperate Americans. We recommend using a Canadian pharmacy that documents the source of the medications they sell. Most don’t, but if you can find one that does, you may be reassured to learn you are getting top-quality product from a country with a robust regulatory system in place.

While saving money is one good reason not to take the first price that comes along, there are more. Insurance generally limits you to 30 days’ supply at the counter, or 90 by mail. If you travel a lot or have a second home, that may not be enough; ordering refills while abroad or even in the next county can be frustrating and, if the mail doesn’t cooperate, potentially risky. Through GoodRX or a Canadian source, you may be able to order significantly more at a time.

Then again, travel itself is risky these days and most of us are staying home as much as possible. The ability to make fewer trips to the pharmacy should also be a consideration.

Now, this tactic won’t work with all medications — some simply aren’t allowed to be dispensed en masse — but with others, larger quantities can legally be filled so there’s no reason you shouldn’t take advantage.

If you’re wondering why insurance plans limit members to 30 or 90 days, the answer is the same as always with insurance: saving money for them. If you ordered a year’s worth of meds and then switched insurers, Plan A would have paid out while Plan B gets your premiums for the next 11 months.

Following the shock (or relief) of getting a new prescription from your physician, it’s comforting to settle into a refill routine, and for most people, that means doing whatever insurance says. The easiest path may not be the cheapest or safest, however. Thanks to the internet and some enterprising Canadians, you have options.


The information posted on this blog and website are for general information only and should never be relied on as specific medical advice for an individual reader.  No financial relationship exists between us and any recommended products or persons mentioned. All material contained here is the property of the Sheldon Sowell Center for Health, PC, and cannot be copied, reprinted, or linked to without our express permission.

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