Why prescription prices vary so much from store to store

“In my 20’s I was diagnosed with lupus,” explains Mandy Felix of La Quinta.

She takes seven medications a day to control the autoimmune disorder, pulling one prescription bottle after another from a paper bag. When she’s in remission, she spends roughly $200 a month on her prescriptions. When she’s not? It could be three times that much.

“One of my prescriptions that I have, out of pocket would be over $1,000!”
It’s business for the multi-billion dollar pharmaceutical industry, but for millions of Americans like Felix, getting meds is real life.

“It’s part of our budget. I can go without groceries one week, but I can’t go without my medication. So it’s a necessity.”

Different prices, same product

But as CBS Local 2 uncovered, the price of prescriptions is a little like the price of groceries. Different stores charge different prices for the same product.

Take Simvastatin. The commonly prescribed cholesterol lowering medication had a different cash price at each of the seven drug stores we called. Prices ranged from as low as $4 at Desert Hospital Outpatient Pharmacy, to as high as $103.49 at the Ralph’s Pharmacy.

Explaining the disparity

Why the disparity?

“Because of the average wholesale price variances, every pharmacy chain has their own formulas for setting up a price,” says Ramesh Upadhyayula, the pharmacist-in-charge at Desert Regional Medical Center. He says no one pays wholesale prices, and that the most popular drugs can be deeply discounted to consumers.

“There are advertised specials. Top 30 drugs you get a better price (for), step outside of that, you’ll pay a lot of money unless you shop around,” Upadyayula warns. “Unfortunately it’s economics. You have to make money somehow.”

Comparing costs

CBS Local 2 asked the area’s largest pharmacies to provide us their price list for the country’s 15 most commonly prescribed drugs. Most gave us a limited response.

CVS Media Relations Director Mike DeAngelis told us “We do not participate in prescription price surveys.” He added, “Proper adherence to prescription medications is one of the most cost-effective ways to improve health outcomes, as it can reduce incidents of more expensive health treatment such as hospitalizations.”
Target Spokesperson Jamie Bastian said “Many factors can impact pharmacy charges including a guest’s insurance plan, price changes from manufacturers, if a provider has named the pharmacy a preferred location and the guest’s deductible, just to name a few.” Bastian offered a link to their $4 generics program.
Walgreens provided a full list of our requested medications. Media relations spokesman Markeisha Marshall also told us “”When choosing a pharmacy, we encourage patients to select one based on pricing, accessibility and the health care and pharmacy services available. It’s important for patients to use a single pharmacy so that pharmacists can monitor their medications and avoid potential drug interactions.”

Walgreens Pharmaceutical Pricing:

Drug Strength Quantity Retail Price Saving’s Club Price Hydrocodone/Paracetamol 5-325 MG 30 $26.99 $22.99 Levothyroxine Sodium 0.05 MG 30 $12.99 $10 Lisinopril 10 MG 90 $39.99 $10 Simvastatin 20 MG 30 $32.99 $10 Metoprolol Tartrate 25 MG 180 $44.99 $20 Amlodipine 5 MG 30 $41.99 $10 Omeprazole 20 MG 30 $69.99 $15 Metformin 500 MG 60 $23.99 $4 Salbutamol (Albuterol-Proair) 108 MCG 8.5 $68.99 $52.99 Atorvastatin 20 MG 30 $151.99 $64.99 Azithromycin 250 MG 6 $41.99 $27.99 Amoxicillin 500 MG 30 $16.99 $5 Alprazolam 0.5 MG 180 $51.99 $39.99 Hydrochlorothiazide 25 MG 90 $16.99 $10 Zolpidem 10 MG 30 $47.99 $36.99 Furosemide 40 MG 90 $39.99 $5 Fluticasone Nasal SP 50 MCG 16 $73.99 $15 Sertraline 100 MG 30 $37.99 $15 Citalopram 20 MG 30 $28.99 $10 Gabapentin 300 MG 90 $102.99 $15 Tramadol 50 MG 60 $32.99 $12 Oxycodone/Paracetamol 5-325MG 30 $21.99 $14.99 Prednisone 10 MG 90 $26.99 $10 Warfarin 5 MG 90 $48.99 $10 Ibuprofen 800 MG 90 $26.99 $10

Apples to apples

We called those seven pharmacies with Felix’s prescription list to find out what each would cost her without insurance. And the results were surprising!

It would cost $569.83 to buy Felix’s drugs in cash at CVS.
Rite Aid charged $559.64 Ralphs charges $522.76
Walgreens totaled $546.53
Walmart charged $277.18 Costco wouldn’t provide us a price for one of the medications, but they came in at $100.15.
The same drugs in cash at Desert Regional Medial Center’s pharmacy cost $101.80, a roughly 82 percent savings from the most expensive drugstore.

How to save

And unfortunately, finding the lowest price for your medication isn’t as easy as calling around. Many factors contribute to the price of what you pay. But being aware of those factors can help you save cash.

For example, many people don’t realize pharmaceutical companies negotiate different prices for different stores, so even if you have insurance, your co-pay for the same drug can vary from place to place.

“It’s a common practice,” says Upadyayula. “It happens all the time.”

“There really are incentives to changing your prescription over (to another pharmacy),” says Felix. “They’ll give a gift card, a shopping card, up to $30, $40 and that can really help offset the costs.”

Drugstores often won’t quote you an insurance price unless they have your prescription in hand, so shopping for the best price with insurance may mean going into the store. And sometimes, a drug is cheaper by not going through your insurance.

At Ralphs and Walmart, we found the thyroid medicine Levothyroxine and the diuretic Furosemide available for just $4 each if you pay in cash. Felix has also found different ways to save on supplements.

“If you email them, and tell them how it’s worked for you, how much they like the product, they’ll start sending you coupons,” she says.

Ralphs offers a AAA discount on drugs. Costco has special members prices.

“If there’s a generic, out there, I highly recommend going that way,” offers Felix “That alone has saved me over $1,000 dollars a month.”

CVS and Rite Aid offer discounted pricing with a health savings card, and Walgreens has a similar savings card that requires a $20 per year subscription.

Felix says having a relationship with your pharmacist and physician can help. They often have access to manufacturer’s coupons that you don’t. But don’t feel married to a particular drugstore.

“I treat my prescriptions as I would any other purchase like I’m making for my family. I shop around, I use coupons, I talk to my pharmacist,” says Felix.

CBS Local 2 also looked into online discount sites and apps like Goodrx. You type in where you live, and the medicine you’re looking for, and it promises to find you the cheapest price in your area. But we found that the prices given didn’t always reflect what those stores were actually charging.

Wading through bills and paperwork has taken Felix a lot of time. But she’s matter of fact about what motivates her.

“It’s really an investment in your health,” she says.