2265 North Clybourn Avenue    Chicago, IL 60614    P: 773.296.6700     F: 773.296.1131

Paying A Lot More At Walgreens (and Sometimes CVS Too)

At WholeHealth Chicago, we really do try to avoid prescribing prescription drugs whenever we can, opting instead for lifestyle changes that can keep you away from a chemical pill you might have to take for the rest of your incarnation.

But sometimes…because we won’t play games with your health you’ll leave with instructions to pick up your medication at the drugstore.

I don’t know if other doctors are doing this, but for new meds I routinely do a quick price comparison, a real eye-opener for many patients. Other times, with someone new to WholeHealth Chicago, I’ll share a price comparison as I review her medication list alongside her drug benefits.

Honestly, if the person has great prescription coverage I don’t spend time on pricing. But occasionally we’ll luck out and our patient will leave the office knowing she’ll be saving a serious amount of money every month.

Understanding drug pricing
First, let’s get a handle on brand name drugs versus generics. Of course there are spectacular differences in price, which is why your insurer hates it when your doc prescribes a brand-name drug. Insurers also didn’t want you to know anything about these high-priced, brand-name drugs and as a result were greatly opposed to the direct-to-consumer drug commercials you’ve been seeing on TV for decades. Here’s a good piece on the mid-1980s controversy.

You’ve also read there can be real differences in quality between brand-name and generic. The brand-name drug goes through an excruciating amount of testing before the FDA allows you to swallow the first pill. Generic drugs come primarily from chemical plants in China and India and are then repackaged in a wholesome-sounding place like Des Moines.

Plus, even though the generic drug manufacturer checks on its own production (fox, please watch henhouse) and signs a statement that its product is identical to the brand-name version, as for quality control at the point of manufacture there is very little. Ranitidine, the recently-recalled generic version of Zantac, probably was contaminated for years with the carcinogen NDMA.

Second, brand-name drug prices are fixed by the manufacturer and protected by its patent. Interestingly, even after the drug goes generic the price of the brand-name version must remain unchanged.

Your prescription for a brand-name drug will cost pretty much the same high price at Costco as at Walgreens. Sometimes, but unfortunately less and less often, a branded drug will be sold for a lower price via a Canadian pharmacy. Using a Canadian pharmacy is just fine, but these days people are discovering that with comparison shopping, price-wise you can do just as well in the US.

Third, when we look at generic drugs prices they’re are all over the place. If you’ve got excellent drug coverage and your insurer will pony up for a generic (some are quite costly), that’s fine. But too often a patient hears from the pharmacist “Your insurer won’t cover it.” The subtext being: “Ask your doctor to prescribe the less expensive, older version that no one uses because it doesn’t work and has terrible side effects. Your insurance will pay for that!”

Eye-popping prices
“Oh,” you tell the pharmacist, “Since it’s a generic, I’ll just pay out of pocket.”

The next thing you know you’re waking up on the floor in front of the pharmacy counter. The pharmacist peers down into your face and gently says, “You fainted. It’s sticker shock. We see it all the time.”

The following table, which compares the prices of two common drugs available both as brand-name and generic (Crestor/atorvastatin and Viagra/sildenafil), will explain why you passed out. The table shows prices for the brand-name version (the higher price) and the generic. Note: the first price is retail, the second is with a goodrx discount card (more on that below).

Yes, if you tell the Walgreens pharmacist you have no insurance and you don’t have a goodrx discount card, she will charge you $576 for brand-name Crestor. She could say “Hey, go online, get a discount card, and walk across the street to the Mariano’s, where it will cost you only $15.” Of course, she’d be unemployed at the end of the day.

Drug Walgreens CVS Osco Mariano’s Costco
Crestor

/atorvastatin

90 tabs

$576/$192 $533/$49 $270/$19 $193/$15 $48/$15

Viagra/sildenafil

30 tabs                         $1376/$553      $1288/$333       $393/$25      $1994/$20         $1146/$19

I could go on. Other drug pricing can be less dramatic, but generally Walgreens (and often CVS) are at the very least three times more expensive than Osco, Mariano’s, and Costco. Walmart and Sam’s Club are about the same as Costco.

Ubiquitous Walgreens
Now you’ll ask yourself “How did I end up using Walgreens, anyway?” Well, let’s face it, like nail salons and foot massage places, Walgreens is everywhere. But in addition you may have gotten instructions from your insurer that Walgreens is their “preferred prescription partner” and that you’ll be able to use your pharmacy coverage there and have a delectably low co-pay of $10 or less.

“But,” you protest, “Is Blue Cross (or United or Aetna or Medicare Part D) actually paying Walgreens $192 for 90 days of Crestor when they could pay $15 at Mariano’s?”

Probably not, but you’ll never actually know. Prescription drug prices negotiated between insurance companies and pharmacy giants include a middleman called a Pharmacy Benefit Manager. Like hospital charges, their math is better hidden than Donald Trump’s tax returns.

But keep in mind that as long as an insurer pays a high price for an inexpensive generic it can pass that high price on to you (or your employer) in the form of higher insurance premiums.

Next steps
I don’t want to make all this sound overly complicated, so here’s what I suggest:

Line up all your medications and write down how much you’re paying out of pocket for each. If all you’re forking over is a roughly $10 co-pay, then great. And if in order to get that price you must use Walgreens, then go ahead and do so.

You can click here to read an older Health Tip on why Walgreens so thoroughly irritates me. Or you can click here to learn how abject company greed made both Walgreens and CVS major players in the current opioid crisis.

If your prescription isn’t covered or if your co-pay is more than $10, go to goodrx.com, look up your drug, and see if you can find it somewhere less expensive. Important note: when you use goodrx pricing, you are not using your insurance.

Just remember, our current healthcare system routinely places profits above your well-being. There’s a reason US lifespans are declining and chronic illnesses are on the rise. You must be a pro-active patient and if you work at it you can…

Be well,
David Edelberg, MD

Leave a Comment


  1. Eileen Harakal says:

    Who would tell us all this if you didn’t! Happy holidays and a healthy new year.

  2. Gina Pera says:

    Hi Dave,

    If you’ll allow, I’d like to round out the picture a bit.

    Walgreen’s has been the ONLY pharmacy to act with the customer/patient in mind during the many years of Concerta generics entering the market.

    It has been a big mess. But the bottom line is: The authorized generic was available but few drugstores would fill prescriptions SPECIFYING IT (by NDC). The exception: Walgreen’s.

    Also: Wegman’s and spotty regional reports about Wal-Mart, Costco, etc.

    The FDA responded to my blog readers’ FDA Medwatch complaints, and we succeeded in getting the first two inferior generics downgraded. That meant consumers no longer had to accept them if their insurance company required they take a generic if available.

    Then this administration appointed a venture capitalist/Heritage Foundation “fellow” as FDA chief.

    Gottlieb scoffed at FDA scientists’ concerns about generic/bioequivalent standards for medications with sophisticated delivery systems. (Janssen’s Concerta uses Alza’s OROS.)

    He pushed through scores of generics, and that included Concerta generics from NINE companies. Concerta is an extremely effective medication for millions of people with ADHD.

    It will be impossible to get enough MedWatch complaints for so many companies, and I suppose that’s what they counted on. Or, they would ignore them anyway.

    Bottom line: CVS-Caremark and many other pharmacies have behaved shamefully. Walgreen’s has come through all over the country for my readers. Some independent pharmacies have taken a financial hit to fill the prescriptions for the authorized generic.

    I suspect Walgreen’s, Wegman’s, independents paid more for the authorized generic.

    I cannot comment on the rest of Walgreens’ pricing. But perhaps this kind of customer service means Walgreens pays more for its medications. Just a thought. 🙂

    Happy New Year to you!

  3. Sarah Hemmer says:

    One more thing about Walgreen’s — they are constantly asking for your “customer ID” for the “discount” that isn’t, on everything you buy. It’s, like, $1 off for every 1,000 points (i.e., $1,000 spent), per the explanation given to me by a Walgreen’s pharmacist recently. And they use your “customer ID” to collect data on you. Why would I, in essence, give away my private buying data to Walgreen’s for free? I wonder (a) what they’re doing with it, (b) how or if they’re safeguarding it, and (c) if they’re selling it while “paying” me a whopping $1 for $1,000 of merchandise bought.

  4. Stephanie says:

    I have been using Walgreens fexofenidine this month for my allergies since that drug is easier on my dry eye syndrome. That generic is made in India. It doesn’t seem to be working as well as the generic fexofenidine from Walmart. Am I dreaming? Where is Walmart’s made?

    • cliffmaurer says:

      Hi Stephanie –

      You very well may not be dreaming, as we hear variations of this a lot. Distributors may change where their supply comes from; best to check the packaging as it should indicate where the drug was made. The in-store pharmacist may be helpful as well. But if you find a version of the drug that works for you, best to make note of it.
      -Dr M

Join our Newsletter

Get health recommendations, delicious and time-saving recipes, medical news, supplement reviews, birthday discounts, and more!

Health Tips

Dr. Edelberg’s Health Tips contain concise bits of advice, medical news, nutritional supplement and pharmaceutical updates, and stress relief ideas. With every Health Tip, you’ll also receive an easy, delicious, and healthful recipe.

When you sign up to receive Health Tips, you can look forward to Dr. Edelberg’s smart and very current observations arriving in your in-box weekly. They’re packed with helpful information and are often slightly irreverent. One of the most common responses to the tips is “I wish my doctor talked to me like this!”

Quick Connect

Get One Click Access to our

patient-portal

The Knowledge Base

Patient education is an integral part of our practice. Here you will find a comprehensive collection of staff articles, descriptions of therapies and nutritional supplements, information addressing your health concerns, and the latest research on nutritional supplements and alternative therapies.

Telemedicine – Now Available at WholeHealth Chicago

In order to maintain your continuity of care, WholeHealth Chicago now offers telemedicine appointments with most of our practitioners. During a telemedicine visit, you and your healthcare provider can review medical history, discuss symptoms, arrange for prescriptions, and more. When necessary, labs and diagnostic imaging can be ordered from a facility near your home, and our Natural Apothecary can ship supplements quickly to your door.

Please contact Patient Services for details and scheduling a telemedicine appointment, or to change a regular appointment to telemedicine by calling 773-296-6700.

We’re looking forward to meeting with you in our virtual consultation room soon.

DIAGNOSE-IT-YOURSELF: COVID-19

Far and away, the commonest phone call/e mail I receive asks about COVID-19 diagnosis.
Just print this out, tape it on your refrigerator door, and stay calm.

ALLERGIES

• Runny nose
• Sneezing
• Red, swollen eyes
• Itchy eyes and nose
• Tickly throat
• No fever

COLD
• Runny nose
• Sneezing
• Sore throat
• Mild muscle aches
• Mild dry cough
• Rarely a low fever

STREP THROAT
• Painful sore throat
• Hurts to swallow
• Swollen glands in neck
• Fever

FLU (Standard seasonal flu)
• Fever
• Dry cough (no mucus)
• Sudden onset over few hours
• Headache
• Sore throat
• Fatigue, sometimes quite severe
• Muscle aches, sometimes quite severe
• Rarely, diarrhea

CORONAVIRUS-COVID 19
• Shortness of breath
• Fever (usually above 100 degrees)
• Dry cough (no mucus)
• Slow onset (2-14 days)
• Mild muscle aches
• Mild fatigue
• Mild sneezing

Recent Health Tips

  • Protecting Yourself From Overdiagnosis

    Bill, a healthy looking guy in his mid-40s, came to WholeHealth Chicago because he wanted to get off Lipitor, the widely prescribed cholesterol-lowering drug. Bill had virtually no risks for heart disease and all four of his grandparents were still alive and quite independent, but a few years ago his cholesterol was on the high side and his doctor insisted on the Lipitor. Arthur has Read More

  • Dying In A Leadership Vacuum: The NEJM Editorial in Context

    By now, you’ve probably read that the editors of the New England Journal of Medicine (NEJM) published an editorial entitled “Dying In A Leadership Vacuum” that asks Americans to work together to vote out Donald Trump because of his dreadful mismanagement of Covid-19 and the subsequent deaths of more than 220,000 Americans. To call the editorial scathing would be putting it mildly. If you don’t Read More

  • IV Immune Boost: Now Is The Time

    Nobody I know was surprised when the president and many of his staff were found to be Covid-19 positive. You can only thumb your nose at science for so long before Mother Nature gets exasperated and lets you have it. To me, the real irony is this: at the same time the upper echelon in Washington is receiving gold-plated medical care, they’re pushing through the Read More

Join our Discount Program

Member benefits include 10% off all your purchases. Low, one-time membership fee of $25 ($35 for family).

MORE INFORMATION

Join our Newsletter

Get health recommendations, recipes, medical news, supplement reviews, birthday discounts, and more!