Contraceptive pill prices have a huge price range

Do you know that the price of a contraceptive pill in Chicago pharmacies varies from $9 (Trinessa, aka generic Tricyclen, at Target pharmacy) to $84 (Loestrin 24 at Kmart pharmacy) a month? That means, over the course of the year, depending on what pill you take and where you shop, you could drop as little as $84 or — let me get my calculator here — $1008! These prices are if you pay out of pocket for your medicines, of course.

“But I have good insurance!” you say. Ok. But a “third tier co-pay” on a birth control pill, such as Loestrin 24,  can still run up to $40 a month. That’ll cost you $480 a year.

“But I want to take the latest, most up-to-date medicine- because it’s better for me, right?”

Better marketed? Yes. Better for you? Not necessarily.  Let’s look at Loestrin 24 for a sec. Loestrin 24’s predecessor, plain old Loestrin, has been around since I was in medical school (um, yes, that would be the early 90’s). At the time it was called Loestrin 21. Over time, as all medicines eventually do, it went generic. The generic version is called either Microgestin or Junel. Old Loestrin/Microgestin/Junel each comes with 21 active (i.e. hormone-containing) pills. Brand new Loestrin 24 comes with 24 active pills. So as far as I can tell that’s the big difference between these different versions of the pill — merely three additional active pills. Now let’s see how those three additional pills affect the price you pay at the pharmacy:

Loestrin 24: $65- $84 per month. Average price $75

Microgestin/Junel 21: $20- $34 per month. Average price $27

Hmm … so those three additional active pills cost an extra $48 a month? That’s almost $13 a pill! Wonder what makes these extra pills so special? My guess is it’s the magic of TV and magazine advertising and marketing.

So why did your doctor give you Loestrin 24 the last time you were in the office? Is she in cahoots with Big Pharma or something? No, no. Not at all. Oddly enough, she was probably trying to save you money by giving you free samples that the drug rep had left at her office.

Or maybe it was the first medicine that popped into her head– because she’s no less susceptible to the drug industry’s multi-billion dollar marketing machine than you are. Or maybe she felt this really was the exact right prescription for you and no other medicine would suffice. The only way to know for sure is to ask her. If you are price-sensitive when it comes to your prescriptions, maybe the two of you could come up with a less costly alternative.

Leslie Ramirez is an internal medicine physician and founder of 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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