How Much Do Prescription Drugs Cost Without Insurance

According to the Organisation for Economic Co-Operation and Development, Americans spend, on average, about $1,200 each year on prescription drugs. The most popular prescription drugs range in cost from $12.41- $97.57. However, there is a lack of price transparency regarding the cost of prescription drugs, making it difficult for consumers to know how much their medications will cost out of pocket.

How Much Prescription Drugs Cost 

Below is a breakdown of the most popularly prescribed prescription drugs in the United States, along with the average out-of-pocket retail cost. The costs range from $12.41- $97.57.

Popular Prescription Drug Retail Costs

Factors that Affect the Cost of Prescription Drugs

Several factors affect the cost of prescription drugs, including generic or brand-name prescriptions, where you get your prescription filled, and how long you are on the medication. 

Generic vs. Brand-Name Drugs

The cost of your prescription drug will largely depend on whether you get the generic or brand-name version. Oftentimes, generic drugs will cost 85% less on average when compared to brand-name, and they offer the same benefits as the brand-name drug. While the difference in cost is steep, it simply has to do with the Food and Drug Administration (FDA) and the regulations set in place.

Once the patent or drug exclusivity for a certain drug expires, other pharmaceutical companies can then develop their own version of the treatment- leading to the drug pricing becoming increasingly competitive. The FDA regulates how generic drugs are manufactured, packaged, and tested, so while your prescription might look slightly different, it will work the same way.

Below you’ll find a chart comparing brand-name medications to generic versions and the differences in costs.

Monthly Prescription Cost Comparing Brand Name vs. Generic Version

The differences you may see when it comes to generic, and brand-name versions include:

• Shape
• Color
• Packaging
• Flavorings
• Inactive ingredients

Where You Get Your Prescription Filled

A survey from Consumer Reports showed that prescription drug prices could vary by as much as 10 times between pharmacies, even if they are in the same city. In the study, secret shoppers called over 200 pharmacies in six cities to ask the prices of several generic drugs to collect this information. They discovered that a drug like Singulair, an allergy medication, can range in price from $15 to more than $140 within a single zip code.

A variety of factors can influence how pharmacies price their drugs, such as:

• Business costs
• Profit margins
• The prices charged by pharmaceutical companies

However, these costs are usually kept confidential. The best way to determine the drug's price is to call the pharmacy before picking it up.

There are ways to discover the lowest drug costs. You can use MiraRx to discover how much prescriptions cost at various pharmacies near you and access a coupon to get them for up to 80% off.

How Long You are Taking the Medication

If you are prescribed a drug for an extended period of time, this will cost you more money out of pocket because you will have to continue to pay for the amount of time prescribed; for some people, this may be for years. 

However, below, we outline several ways you can save money on medications -- one is asking for a 90-day prescription compared to a short time frame.

Getting Prescription Drugs Without Insurance

While prescription drugs can be expensive without insurance, there are several ways to save money:

Prescription Assistance Programs: Prescription assistance programs help patients pay for the medications at an affordable rate. Pharmaceutical companies create them to provide free or discounted prescriptions for those who need them. Patients usually have to apply to receive assistance.

Call different pharmacies: As stated above, you will oftentimes find that different pharmacies will offer various rates for the same prescription. Therefore, before choosing a pharmacy, you may want to call around to see which pharmacy offers the best price.

Ask for a 90-day supply: While a 30-day refill option is usually the most common, a study found that getting a 90-day supply of medication can save patients a significant amount of money. However, this option is only appropriate if you are taking maintenance medications.

Use coupons: Before purchasing your prescription, you can look around for coupons that will save you money. One way to do this is by using MiraRx, where you can look at discounts from different pharmacies in your area and choose the best price.

How Prescription Costs Are Determined

Prescription drug price negotiations are determined by pharmaceutical companies, pharmacy benefit managers, and health insurance companies. Below we go into detail about how each plays a role.

Pharmaceutical companies. Pharmaceutical companies make and sell drugs but don’t break down pricing or why costs can greatly exceed research-and-development (R&D) expenses. Some pharmaceutical companies will purchase existing drugs and still raise prices.

Pharmacy benefit managers (PBMs). PBMS works on behalf of health insurance companies or employers and negotiates upfront discounts on the prices of prescription drugs with pharmaceutical companies, as well as rebates, which reward favorable coverage of a particular drug (and the resulting increase in utilization by a health plan’s patients). These prescription drug agreements are kept secret, so it is unknown if savings ever reach the patients.

Health insurance companies. Health insurance companies are responsible for approving treatments, setting co-pays, and determining prices along with PBMs to evaluate how much patients pay for drugs. Often, they decide on coverage options based on what maximizes company profits.

Since the determination of most prescription drug costs involves very little transparency toward the consumer, organizations are working to improve this process.

Prescription Drug Costs Frequently Asked Questions (FAQs)

Prescription drug costs can be confusing, and you may not always know how to navigate them. Below we answer several frequently asked questions. 

Are prescriptions always less expensive with insurance?

Not always; and there are a few reasons why your prescription will cost more using insurance:

Your insurance doesn’t cover the medication: Insurance companies may not cover all prescription drugs. You can check your insurance’s formulary to see what drugs your insurance covers and does not. A formulary is a list of generic and brand-name prescription drugs that are covered by your health plan. If the prescription isn’t covered, it may be cheaper to use a drug assistance program or a coupon. 

You haven’t met your deductible: Some insurance plans don’t cover the cost of prescription drugs until you’ve met your deductible (the amount you have to pay before insurance starts paying). Therefore, you have to pay attention to see if you have met your deductible before your insurance starts paying for prescriptions.

There are high copays: If you have an insurance plan that starts paying before you reach your deductible, you will have to pay either a copayment or coinsurance. This out-of-pocket expense will vary depending on the drugs you take. If it’s a low-cost generic drug, you might have a lower deductible, but your copay might be higher if it’s a brand-name prescription drug.

How are prescriptions priced?

Due to a lack of cost transparency, it remains fairly unclear how prescription drugs are priced. However, a large factor that’s apparent in determining the cost is the market for the drug. If the market (or condition being treated) already has several competing medications, a new drug will likely be sold at a competitive price.

However, a drug for a condition with few competitors will likely be priced at a higher rate. This is due to the cost consumers will be willing to pay since there are no other treatments. 

Which type of prescription is the most expensive?

The type of prescriptions that are the most expensive or considered “breakthrough” therapies, in which they are used to treat a serious or life-threatening condition or disease. Zolgensma is the most expensive drug in the U.S. with an estimated annual cost of $2,125,000 and treats spinal muscular atrophy (SMA), a rare disorder caused by a defective gene.

Bottom Line

Popular prescription drugs range in cost from $12.41- $97.57, and the prices are determined based on whether you can use generic or brand-name drugs. It’s important to find an affordable way to access medications if you don’t have insurance, whether by using coupons, calling pharmacies, or using MiraRx.