Pharmacies can charge different prices for their prescription drugs

Most of the American public doesn’t know that different pharmacies can and do charge drastically different prices for their prescription drugs. Does that surprise you?  It sure surprised me when I found this out a few months ago in my medical school class.

I consider myself well educated. I’m a college graduate and in the throes of professional school — in healthcare nonetheless. I have an open mind and I read quite a bit. But I still wouldn’t have guessed that Coumadin would cost my uninsured father in Texas $15 for thirty pills at CVS, but only $4 for the same number of tablets at Walmart (I can actually vouch for this number).

I would have thought it was safe to assume that drug prices are comparable across the board. After all, that’s how it usually works, right? When I buy gum, I have faith that I won’t pay triple the price at one convenience store compared to another. But with pharmacies, this just isn’t the case.

When we call a shopper “smart,” we assume that there are options to choose from and information to help choose between those options. That’s the market, and it keeps costs down for the consumer while encouraging the suppliers to find bigger and better ways to provide their product. If we don’t have options, or we don’t have information, we can’t have “smart” shoppers. A convenience store can charge me $6 dollars for gum, and if I have no way of knowing that gum usually costs $2, I’ll pay it. I can’t be running around with bad breath.

That’s why transparency is so important to the prescription medication consumer. Few of us have any idea as to how much drugs should cost. And, since many states don’t require their pharmacies to release their drug costs unless someone is buying them, the consumer has no convenient way of amassing the information it needs to choose from the options. Sure, I could make a trip to every nearby pharmacy and ask, but when is the last time you called ten different airlines to find the lowest price? When I buy airfare, I use one website that shows me the lowest fares for my trip from a range of different flight providers.

Why should buying prescription drugs be any different? What’s more, a transparent pharmaceutical pricing system seems to make sense no matter what side of the political spectrum you call home. For conservatives: don’t you love a market that pits different companies against each other to increase performance and lower costs? For liberals: isn’t affordable medicine for the uninsured enticing? It works for everyone and it’s the right thing to do, so let’s get it done.

Arvin Akhavan is a medical student who blogs at Leslie’s List, which provides information that enables all patients, but especially the uninsured and underinsured, to find more affordable medications and health care services.

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  • Elizabeth Diop

    yeah– i knew this. i think people without insurance are typically aware of the price differences at different pharmacies. i regularly call around- walgreens has great hours, but is usually more expensive. kroger is closer to me, and walmart is usually cheapest……….

  • bojimbo26

    I live in the UK , and have been to 6 different pharmacies all charging different prices for the same item . It’s a known fact . Designer packaging cost more , ingrediants are the same . ( You pay for the packaging ) .

  • EdmundHayes

    Is this such a big surprise to anyone? I can’t think of an item that is sold that can not be found at a less expensive price somewhre else. My God, that is how Amazon stays in business. I can buy lets say Centrum vitamins at Costco, Amazon or a independent pharmacy. Does anyone think the prices will all be exactly the same.
    Has anyone purchased a car ever in their lives? Did they shop around? Did they find large differences in the prices, from dealer to dealer?
    Prescription eyeglasses can be purchased also at Costco at 1/2 the price as the local Optometrist.
    Physicians charges are not the same across the board and dentists do the same. My wife and I go to 2 different dentists. We both recently had relatively the same work done. My fancy “cosmetic” dentist charges almost twice as much as my wifes dentist.
    In pharmacy the prices do not vary that much as this.
    Everyone should shop around no matter what hey are buying, priscription drugs included.
    In New York, pharmacies are required by law to post a large display of the their top 100 selling drugs and post the prices of those drugs. Good idea? Maybe, but does any other profession or store do the same? The answer is NO!
    Will Leslie, when she finishes medical school and begins to practice post a sign in her reception area of exactly what she charges for every thing she does.
    My advice is to shop around like EVERYONE of us does for EVERY OTHER thing we buy.PS – As far as I know most people have prescription plans of some sort and co-pays are the
    same regardless of what the pharmacy charges the insurance company.

  • Jerry Fahrni

    I’m a little surprised that anyone wouldn’t know,
    or at least logically suspect, that prescription medications may have different
    retail costs depending on the store. Medications, like all other items on the
    shelves in the pharmacies, are for sale. They’re used to generate
    profit in some stores, while act as loss leaders in others. The only time “retail
    prices” are fixed is when insurance companies set the reimbursement rate. I’m
    sure that most pharmacies make an effort to be competitive, but pricing is different
    from place to place and depends on lots of variables. It you’re not using
    insurance to fill your scripts, it’s really no different than buying shampoo, razors,
    soft drinks or anything else on the shelf

    • David Falkner

      The point is that the prices are essentially UNKNOWN until most people have it filled and are checking it out. Have you ever shopped around for a medication that ISINT on a $4 or $10 list? It’s a nightmare, & for the elderly who are unable or have no idea what kind of markup is on their meds. This is almost bait-and-switch. Prices should be available publicly (like other store goods) regardless of how much profit is made. I get (*had) blood pressure meds filled at Walgreens and have their savings plan. Just this month they jacked the price of my meds (right when I NEED them) over 300%, how convenient ehh? After I just gave them $20 for discounted pricing for the year, I only got reduced prices for 3 months. Store can make money but buying meds shouldn’t be like buying a car.

  • neuroscience101


  • euonymous

    Unless it’s a relatively inexpensive, one time prescription, like an antibiotic, I have always researched costs before venturing into any prescription that will need refilling. Coumadin is not $6 at CVS and $4 at Wal-Mart (in Massachusetts) unless you have some incredible insurance plan. I’m paying over $89 (after Blue Cross/Blue Shield paid its pittance) to refill two brand name Coumadin prescriptions (I react badly to the generics which are, indeed, $4 at Wal-Mart) at the cheapest place I could find… which was my local, employee owned, supermarket pharmacy. My prescriptions at Wal-Mart came to $129 (just called to check), thank you very much. One of the things you’ll learn as you encounter patients on long term warfarin is that the generics are not all the same (!) and they cause very bad reactions in some people.

    Gum does not vary from $6 to $2 because (1) the prices are posted everywhere for eveyone to see, (2) it is generally an impulse purchase, and (3) it is available everywhere you might shop from a gas station to a supermarket, so pricing is competitive. Pricing for drugs is secretive; the products are critical and limited in distribution. No surprise that prices vary along with the profitability, overhead, and ethics of the seller. Welcome to the real world, Arvin. And this is one more reason why the USA needs universal healthcare.

  • Arnold Wax

    This is all because the United States is the only nation in the world that does not regulate the pharmaceutical industry. In addtion, the pharmaceuticial industry bought itself out of the ACA.

  • PMD1234

    Once you start dealing with patient who have part D ( with a donut hole)but a lot of medications , or chose not to have a medication plan, or couldn’t afford one- you get adept at naming the local pharmacies with the cheapest drugs. ( Target , Walmart and Costco in our area- they are close to each other so in tight competition ) The most expensive- usually CVS.
    If they have hit the donut hole- it is cheaper to pay cash off their policy.
    Agree with the optometrist- some Costcos also sell hearing aids.
    Agree it is a sign of the horrible Darwinian approach to medicine this country has adopted- and remember that in poorer areas- there is no choice of pharmacies, and many will not deliver.
    ( A local pharmacy does- the prices aren’t way off, and the delivery is a lot cheaper than a taxi or bus ride- this may be the best option for frail senior with working families)
    But this is a perfect example of how physicians also end up being social workers- and there is no code for this.

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