I read this comment written by Dilip Sarwate:

It sometimes depends on the circumstances. If your doctor tells you to take one 81mg tablet of aspirin as a countermeasure against future heart attacks, it is not covered. If the doctor prescribes the same medication, it might be covered by health insurance, and the pharmacy will dispense it to you as a prescription drug, but the copay will likely be larger than what the same medication will cost you over the counter.

How can I make sure that I don't pay a copay that isn't more expensive than over-the-counter when buying drugs in the United States?

  • Should I simply systematically ask the price of the drug when bought over-the-counter before giving any prescription to the pharmacist?

  • Since the price of over-the-counter drugs may greatly vary between pharmacies, should I use some databases such as GoodRx to ensure the cheapest over-the-counter price possible?

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    "Should I simply systematically ask the price of the drug when bought over-the-counter before giving any prescription to the pharmacist?" - yes, that. Or if you fulfill your prescriptions online, a simple search will do the same thing. – Joe Strazzere Feb 2 '17 at 17:38
  • @JoeStrazzere Thanks. "simple search" --> you mean to look for and compare over-the-counter prices? – Franck Dernoncourt Feb 2 '17 at 17:39
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    The online site I use when ordering my prescription drugs makes it easy to find equivalents and compare prices. If your site doesn't then Google can do the same. – Joe Strazzere Feb 2 '17 at 17:40
  • @JoeStrazzere Did you choose the online site you use when ordering my prescription drugs? Or is that given by your insurance? – Franck Dernoncourt Feb 2 '17 at 17:51
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    It is given by my insurance. – Joe Strazzere Feb 2 '17 at 18:02

Your doctor may very well know. Mine almost always mentions that "I can prescribe you X, but it's essentially the same as doing Y which is cheaper, but some people have side effects with Y that they don't have with X." They deal with this stuff all the time, and often have patients that are on limited budgets.

You can also call or talk to the pharmacist in person to ask for the pricing of the drug on your insurance. They are also knowledgeable in the differences between an OTC version of a drug and a pharmacy dispensed one. Having worked in that industry, I will say that the active ingredients are only one part of the cocktail of a medicine. Everything else that goes into a pill has an effect on how well it works, and if you will have a reaction to it. In theory, a generic is an identical medicine mechanically to a non-generic version, but in practice some people have bad reactions to the generic they don't have with the non-generic (and the opposite is true as well). The pharmacist is required to know, or have access to the information, on side effects and interactions on all medicines they dispense, and most will know the same for the OTC versions.

  • Thanks. You are lucky to have such a physician. It's very rare (<5%) that a physician tells me on which drug to buy from the price standpoint. Some pharmacists will not tell any price by phone, and since over-the-counter prices vary between pharmacies that sounds quite time-consuming. – Franck Dernoncourt Feb 2 '17 at 17:38
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    it's a cost vs benefit analysis really. If your copay is $10 for your drugs, it doesn't make a lot of sense to spend the time (bc many OTC are probably between $5-20). If it's $100, then it's worth the time. – Marshall Tigerus Feb 2 '17 at 17:42
  • I agree. I was hoping for a less time-consuming solution :) E.g. Over-the-counter prices of pharmaceutical drugs in the United States – Franck Dernoncourt Feb 2 '17 at 17:52

You should get in the habit of talking to your pharmacists about the relative costs of these medicines. They are very knowledgeable and can easily provide those recommendations for cost conscious customers. My wife regularly consults our pharmacist about the relative costs of the drugs and their generics since we pay for them out of our high deductible rather than having a co-pay.


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