CAN TRANSPARENCY REDUCE
RETAIL PHARMACEUTICAL PRICE DISPARITIES
OR LOWER COSTS FOR CONSUMERS?
Marc A Rodwin, J.D., Ph.D.
Suffolk University Law School
Transparency in Health and Health Care:
Legal and Ethical Possibilities and Limits
2017 Harvard Law School Petrie-Flom Center
April 28, 2017
3 commonly asserted propositions re Rx transparency
1) Prescription drug prices lack transparency.
2) Lack of price transparency is new and contributes to wide
price variations.
3) Increasing transparency is sufficient to reduce price
variation and lower prices.
Better supported alternative propositions
1) There was little pharmaceutical price transparency in the
1960s due to restrictions on advertising and the lack of
technology to facilitate learning prices. These obstacles
have since been removed.
1) Variation in retail prescription drug prices in the U.S. has
existed since the mid-1960s and persists despite recent
increased price transparency.
1) Other factors explain wide prices variation and high prices:
Other factors explain wide prices variation and high prices:
a) Retailers, Pharmaceutical Benefit Managers (PBMs) and
manufacturers price discriminate to increase revenue.
b) Insurance copayment policies result in some consumers
paying more than others for identical medications.
c) High transaction costs deter consumers from comparing
prices effectively or purchasing medication based on price.
d) Wide price variation is due to retailers, PBM and
manufacturers marketing strategies and the absence of perfect
competition.
1967. Hastings, Glen E., and Richard Kunnes. "Predicting prescription prices." New England Journal
of Medicine 277, no. 12 (1967): 625-628.
1970. What is the price of an Rx Drug? Consumer Reports 35 no. 5 279 (May 1970)
1973. Wertheimer, Albert I. "Pricing pharmaceutical service—art, science or whim." Journal of the
American Pharmaceutical Association 13, no. 1 (1973): 11-12, at 11.
1975. Cady, John F., and Alan R. Andreasen. "Price levels, price practices and price discrimination in a
retail market for prescription drugs." The Journal of Consumer Affairs (1975): 33-48.
1977. Berki, S. E., J. W. Richard, and H. A. Weeks. "The mysteries of prescription pricing in retail
pharmacies." Medical care 15, no. 3 (1977): 241-250.
Wertheimer, Albert I. "Pricing pharmaceutical service—art, science or whim." Journal of the American
Pharmaceutical Association 13, no. 1 (1973): 11-12, at 11.
1986. Bloom, Bernard S., David J. Wierz, and Mark V. Pauly. "Cost and price of comparable branded
and generic pharmaceuticals." JAMA 256, no. 18 (1986): 2523-2530.
Uninsured
1) Low cost generics sold at for $4 to $10 for
a 30 day supply.
• Low cost list varies with pharmacy.
2) Other generics branded drugs sold at many
prices by each pharmacy.
• In Boston 6 chains, 1 mail order retailer;
many independent. Pharmacies.
A) List price;
B) Membership discount;
C) Discounts through phone apps vary with
pharmacy and phone app.
• Good RX
• Well Rx
• Rx Price Quotes
• Easy Drug
3) Pet med web sites sell human drugs
sometimes at lower price than pharmacies.
Insured
1)Co-payments vary with market segment and
insurer.
2) Copayments vary with which of 3 to 5
copayment tiers the drug is placed.
3) Purchasing drug without insurance from
low-price drug list or with discount coupon is
sometimes less expensive paying the insurance
copayment.
4) Pet med web sites sometimes charge lower
prices than standard pharmacies.
PRICES List
Price
Member
Discount
Good
Rx
Well
Rx
Price
Quotes
Easy
Drug
RETAILER
CVS
Rite Aid
Wallgreens
Costco
Walmart
Health
Warehouse
Table 4: Summary of Prices Compared in Survey for each medication
PRESCRIPTION
DRUG
HIGHEST FIRM
LOWEST
FIRM
2ND
LOWEST FIRM
PRICE
DIFFERENCE
MEAN
PRICE
Aripiprazole;
Abilify
Walgreens: $944.09 Costco: $90.47 CVS:
$158.81
$68.34 $522.35
Fluticasone:
Advair
Rite Aid: $330.39 Costco: $150.39 Walmart:
$153.16
$2.77 $232.52
Albendazole:
Albenza
CVS: 5511.92 Costco: $5005.55 Walmart
$5253.81
$248.26 $5,380.04
Captopril:
Capoten
CVS: $81.14 Costco/Walmart:
$8.54
Rite Aid:
$9.99
$1.45 $26.35
Clomipramine:
Anafranil
H Warehouse: $333.0 Walgreens: $10 CVS:
$106.06
$91.06 $197.20
Duloxetine:
Cymbalta
Walgreens: $231.99 H Warehouse: $15.75 Walmart:
$25.74
$9.99 $109.36
Digoxin:
Lanoxin
Walmart/
Costco: $69.15
Walgreens: $5 Rite Aid: $10 $4.99 $34.02
Table 5: Summary of Retail Price Variation for 21 Drugs:
Highest price, lowest price, 2nd-lowest price, $ difference between lowest and 2nd
lowest price, and mean price (Part 1)
Prescription
Drug
HIGHEST FIRM
LOWEST
FIRM
2ND
LOWEST
FIRM
PRICE
DIFFERENCE
MEAN
PRICE
Doxycycline:
Monohydrate
Monodox
Walmart: $124.54 H Warehouse:
$14.98
Walgreens:
$15
$0.02 $56.02
Doxycycline
Hyclate:
Vibramycin
CVS: $182.81 Rite Aid: $9.99 Walgreens:$15 $5.25 $69.67
Erythromycin:
Erythrocin
H Warehouse:
$660.90
Costco: $61.19 CVS: $183.29 $122.10 $431.94
Atorvastatin:
Lipitor
Rite Aid: $149.99 H Warehouse:
$6.30
Costco: $9.95 $3.65 $64.12
Metformin:
Glucophage
Walmart: $29.06 Walmart: $4 Walgreens/
H Warehouse:$5
$1 $10.33
Methazolamid
e:
Neptazane
CVS: $185.78 CVS: $31.36 Walgreens:
$47.34
$15.98 $95.55
Clopidogrel:
Plavix
Rite Aid: $152.99 H Warehouse:
$7.90
Walmart:
$18.48
$10.58 $73.86
Table 5: Summary of Retail Price Variation for 21 Drugs:
Highest price, lowest price, 2nd-lowest price, $ difference between lowest and 2nd
lowest price, and mean price (Part 2)
PRESCRIPTI
ON DRUG
HIGHEST
FIRM
LOWEST
FIRM
2ND
LOWEST
FIRM
PRICE
DIFFERENCE
MEAN
PRICE
Pioglitazone:
Actos
Rite Aid:
$347.99
H Warehouse:
$6.95
Costco:
$14.57
$7.62 $131.85
Piroxicam:
Feldene
Rite Aid:
$123.34
Walmart:
$48.04
CVS:
$51.16
$3.12 $72.40
Pravastatin:
Pravachol
CVS: $65.31 Walgreens: $5 Rite Aid:
$9.99
$4.99 $23.75
Amitriptyline:
Ranexa
Walgreens:
$508.47
Costco :
$154.01
Walmart:
$154.06
$0.05 $279.60
Risperidone:
Risperdal
Rite Aid:
$119.99
Costco: $8.80 Walgreens:
$15
$6.20 $53.21
Montelukast:
Singulair
Rite Aid:
$169.99
H Warehouse:
$8
Costco:
$11.27
$3.27 $66.97
Olanzapine:
Zyprexa
CVS:
$436.99
H Warehouse:
$11.85
Costco:
$12.40
$0.55 $189.06
Table 5: Summary of Retail Price Variation for 21 Drugs:
Highest price, lowest price, 2nd-lowest price, $ difference between lowest and 2nd lowest price, and mean
price (Part 3)
PHARMACY Lowest $ amount between
highest and lowest price
for a single medication
Highest $ amount between
highest and lowest price for
a single medication
$ amount
between lowest
and highest price
difference
Mean savings
when
purchasing at
lowest price*
Health Warehouse $0
(Aripiprazole Digoxin,
Erythromycin, Piroxicam,
Risperidone. No price
difference
$14.12
(Doxycycline)
$14.12 $3.47
Costco $1.85
(Metformin)
$590.11
(Aripiprazole)
$588.26 $150.98
CVS $12.11
(Metformin)
$731.18
(Aripiprazole)
$719.07 $172.18
Rite Aid $6.03
(Metformin)
$507.06
(Aripiprazole)
$501.03 $145.11
Walgreens $10.07
(Metformin)
$674.93
(Aripiprazole)
$664.86 $149.64
Walmart $10.92
(Methazolamide)
$232.70
(Olanzapine)
$221.78 $91.58
Table 6: Range of prices offered within a single pharmacy:
Lowest $ difference between high and low price; highest $ difference between high and low price; Mean
saving by purchasing drug at lowest price.
Price Variation
within one Pharmacy
Table 7A CVS Generic Drug Pricing
Pharmacy/Plan
Name Dose Listed Price
Generic
GoodRX
Coupon Well Rx
Rx Price
Quotes Easy Drug
Caremark
Price
(Generic)
Caremark
Price (Brand) -
Mail service
Price
Difference
(High to
Low) Mean All generics
Abilify
(Aripiprazole) 2mg $ 889.99 $ 158.81 $ 681.82 $ 844.85 $ 584.49 $ 299.44 $ 295.77 $ 731.18 $ 522.35
Advair 100/50mcg N.A. N.A. N.A. N.A. N.A. N.A. N.A. N.A. N.A.
Albenza
(Albendazole) 400mg N.A. N.A N.A N.A N.A N.A. N.A. N.A N.A.
Capoten
(Captopril) 12.5mg $ 27.19 $ 19.91 $ 27.19 $ 11.92 $ 34.55 $ 81.14 $ 72.56 $ 69.22 $ 26.35
Anafranil
capsules
(Clomipramine) 50mg $ 266.99 $ 106.06 $ 243.58 $ 121.00 $ 208.85 $ 281.25 N.A. $ 175.19 $ 197.20
Cymbalta DR
capsule
(duloxetine) 20mg $ 195.99 $ 41.85 $ 96.45 $ 189.41 $ 132.47 $ 71.88 $ 63.10 $ 154.14 $ 109.36
Lanoxin
(Digoxin) .125mg $ 39.39 $ 10.97 $ 33.49 $ 12.14 $ 47.90 $ 49.30 $ 29.47 $ 38.33 $ 34.02
Monodox
(Doxycycline) 100mg $ 56.59 $ 33.27 $ 73.32 $ 44.14 $ 95.07 $ 36.91 $ 28.00 $ 67.07 $ 56.02
Doryx
(Doxycycline
hyclate) 100mg $ 89.59 $ 45.70 $ 76.80 $ 46.42 $ 106.08 $ 182.81 $ 80.87 $ 137.11 $ 69.67
Ery-Tab
(Erythromycin) 500mg N.A. $ 289.64 $ 497.99 $ 183.29 $ 444.40 $ 327.24 $ 439.50 $ 314.70 $ 431.94
Lipitor
(atorvastatin) 20mg $ 134.99 $ 19.11 $ 69.98 $ 90.08 $ 110.31 $ 60.96 $ 51.99 $ 91.20 $ 64.12
Glucophage
(Metformin) 500mg $ 11.99 $ 12.81 $ 11.33 $ 13.05 $ 19.19 $ 17.10 $ 7.08 $ 12.11 $ 10.33
Table 7A CVS Generic Drug Pricing continued
Pharmacy/Plan
Name Dose
Listed
Price
Generic
GoodRX
Coupon
Price Well Rx
Rx Price
Quotes Easy Drug
Caremark
Price
(Generic)
Caremark
Price
(Brand) -
Mail service
Price
Difference
(High to
Low) Mean All generics
Neptazane
(Methazolamide) 25mg $ 105.99
**48.49
(50mg) $ 87.95 $ 31.36 $ 75.46 $ 185.78 $ 179.55 $ 154.42 $ 95.55
Plavix
(clopidogrel) 75mg $ 141.99 $ 85.15 $ 80.11 $ 112.01 $ 131.80 $ 73.11 $ 64.35 $ 77.64 $ 73.86
Actos
(Pioglitazone) 45 mg $ 305.99 $ 25.92 $ 251.46 $ 182.78 $ 215.67 $ 115.03 $ 107.22 $ 280.07 $ 131.85
Feldene
(Piroxicam) 20mg $ 79.99 $ 51.30 $ 51.16 $ 53.86 $ 87.25 $ 75.10 $ 66.39 $ 36.09 $ 72.40
Pravachol
(Pravastatin) 20mg $ 33.99 $ 22.59 $ 25.93 $ 36.87 $ 65.31 $ 37.49 $ 27.93 $ 42.72 $ 24.46
Ranexa (ER 12 h) 500mg $ 424.79 $ 364.53 $ 359.53 $ 188.26 $ 155.63 N.A. N.A. $ 60.26 $ 279.60
Risperdal
(Risperidone) 1mg $ 93.59 $ 19.14 $ 48.91 $ 76.73 $ 88.40 $ 79.84 $ 71.24 $ 74.45 $ 53.21
Singulair
(Montelukast) 10mg $ 128.99 $ 22.48 $ 68.13 $ 95.26 $ 108.33 $ 69.88 $ 61.05 $ 106.51 $ 66.97
Zyprexa
(Olanzapine) 10mg $ 436.99 $ 27.35 $ 96.30 $ 309.14 $ 364.98 $ 189.65 $ 183.51 $ 409.64 $ 189.06
average: $ 159.58
Table 7B RiteAid Generic Drug Pricing
Pharmacy/
Plan Name Dose Listed Price
Generic
GoodRX
Coupon Price Well Rx
Rx Price
Quotes Easy Drug
Membership
price (Generic)
High Phone
App Price
Low Phone
App Price
Difference
high to low
Abilify
(Aripiprazole) 2mg $ 899.99 $ 944.07 $ 437.01 $ 844.35 $ 439.99 N.A. $ 944.07 $ 437.01 $ 507.06
Advair 100/50mcg N.A N.A N.A N.A N.A N.A. N.A. N.A. N.A.
Albenza
(Albendazole) 400mg N.A N.A N.A N.A N.A N.A. N.A. N.A. N.A.
Capoten
(Captopril) 12.5mg $ 44.99 $ 9.99 $ 25.05 $ 28.44 $ 27.54 $ 9.99 $ 44.99 $ 9.99 $ 35.00
Anafranil
capsules
(Clomipramine) 50mg $ 308.99 $ 142.40 $ 155.76 $ 299.67 $ 158.26 N.A. $ 308.99 $ 142.40 $ 166.59
Cymbalta DR
capsule
(duloxetine) 20mg $ 199.99 $ 91.40 $ 98.48 $ 188.91 $ 100.98 N.A. $ 199.99 $ 91.40 $ 108.59
Lanoxin
(Digoxin) .125mg $ 9.99 $ 9.99 $ 35.05 $ 57.41 $ 37.55 $ 9.99 $ 57.41 $ 9.99 $ 47.42
Monodox
(Doxycycline) 100mg $ 99.99 $ 81.26 $ 70.43 $ 46.17 $ 72.93 N.A. $ 99.99 $ 46.17 $ 53.82
Doryx
(Doxycycline
Hyclate) 100mg $ 110.09 $ 81.26 $ 78.68 $ 41.31 $ 81.18 $ 9.99 $ 110.09 $ 9.99 $ 100.10
Ery-Tab
(Erythromycin) 500mg N.A. $ 236.71 $ 516.99 $ 504.78 $ 439.57 N.A. $ 516.99 $ 236.71 $ 280.28
Lipitor
(Atorvastatin) 20mg $ 149.99 $ 36.09 $ 81.94 $ 111.56 $ 84.36 N.A. $ 149.99 $ 36.09 $ 113.90
Glucophage
(Metformin) 500mg $ 9.99 $ 9.99 $ 13.50 $ 10.33 $ 16.02 $ 9.99 $ 16.02 $ 9.99 $ 6.03
Table 7 B RiteAid Generic Drug Pricing continued
Pharmacy/
Plan Name Dose
Listed
Price
Generic
GoodRX
Coupon
Price Well Rx
Rx Price
Quotes
Easy
Drug
Members
hip price
(Generic)
High Phone
App Price
Low
Phone App
Price
Difference high to
low
Neptazane
(Methazolami
de) 25mg
$
114.99 $ 130.09 $ 55.72 $ 83.38
$
58.22 N.A. $ 130.09 $ 55.72 $ 74.37
Plavix
(Clopidogrel) 75mg
$
152.99 $ 21.16 $ 97.97 $ 91.76
$
100.47 N.A. $ 152.99 $ 91.03 $ 61.96
Actos
(Pioglitazone)
45
mg
$
347.99 $ 146.91 $ 155.88 $ 21.16
$
163.38 N.A. $ 347.99 $ 21.16 $ 326.83
Feldene
(Piroxicam) 20mg
$
85.99 $ 61.34 $ 64.57 $ 123.34
$
67.07 N.A. $ 123.34 $ 61.34 $ 62.00
Pravachol
(Pravastatin) 20mg
$
9.99 $ 9.99 $ 48.10 $ 20.78
$
50.61
$
30.00 $ 50.61 $ 9.99 $ 40.62
Ranexa (ER
12 h)
500m
g
$
439.99 $ 358.03 $ 363.53 $ 187.51
$
154.76 N.A. $ 439.99 $ 154.76 $ 285.23
Risperdal
(Risperidone) 1mg
$
119.99 $ 62.12 $ 65.45 $ 25.69
$
67.93 N.A. $ 119.99 $ 25.69 $ 94.30
Singulair
(Montelukast) 10mg
$
169.99 $ 75.39 $ 80.28 $ 39.88
$
82.87 N.A. $ 169.99 $ 39.88 $ 130.11
Zyprexa
(Olanzapine) 10mg
$
306.53 $ 246.48 $ 272.86 $ 19.13
$
275.36 N.A. $ 306.53 $ 19.13 $ 287.40
Table 7 C: Walgreens Generic Drug Pricing
Pharmacy/Plan
Name Dose Listed Price
Generic
GoodRX Well Rx
Rx Price
Quotes
Easy
Drug
Membership
price
High Phone
App Price
Low Phone
App Price
Price
Difference
(High to Low) Mean All generics
Abilify
(Aripiprazole) 2mg $ 944.09
$
317.25 $ 269.16 $ 844.10 $ 396.64 N.A. $ 944.09 $ 269.16 $ 674.93 $ 522.35
Advair
100/50m
cg N.A N.A. N.A. N.A. N.A. N.A. N.A. N.A. N.A. N.A.
Albenza
(Albendazole) 400mg N.A N.A. N.A. N.A. N.A. N.A. N.A. N.A. N.A N.A.
Capoten
(Captopril) 12.5mg $ 29.89
$
15.35 $ 29.36 $ 13.22 $ 25.43 $10.00 $ 29.89 $10.00 $ 19.89 $ 26.35
Anafranil capsules
(Clomipramine) 50mg $ 259.69
$
32.36 $ 234.05 $ 32.92 $ 143.09 $15.00 $ 259.69 $ 147.31 $ 112.38 $ 197.20
Cymbalta DR
capsule (Duloxetine) 20mg $ 231.99
$
76.18 $ 74.94 $ 188.66 $ 91.53 N.A. $ 231.99 $ 74.94 $ 157.05 $ 109.36
Lanoxin (Digoxin) .125mg $ 42.95
$
15.64 $ 31.22 $ 14.58 $ 34.45 $5.00 $ 42.95 $5.00 $ 37.95 $ 34.02
Monodox
(Doxycycline) 100mg $ 58.79
$
32.90 $ 57.45 $ 50.94 $ 66.28 $15.00 $ 66.28 $15.00 $ 51.28 $ 56.02
Doryx
(Doxycycline
Hyclate) 100mg $ 95.99
$
52.23 $ 51.13 $ 57.83 $ 73.72 $15.00 $ 95.99 $15.00 $ 80.99 $ 69.67
Ery-Tab
(Erythromycin) 500mg $531.53 N.A. $ 513.99 $ 504.53 $ 443.19 N.A. $531.53 $ 443.19 $ 88.34 $ 431.94
Lipitor
(Atorvastatin) 20mg $ 134.99
$
58.00 $ 36.60 $ 138.32 $ 76.57 N.A. $ 138.32 $ 36.60 $ 101.72 $ 64.12
Glucophage
(Metformin) 500mg $5.00 $5.00 $ 7.32 $ 10.28 $ 15.07 $5.00 $ 15.07 $5.00 $ 10.07 $ 10.33
Table 7C Walgreens Generic Drug Pricing continued
Pharmacy/
Plan Name Dose
Listed
Price
Generic
GoodRX
Coupon Well Rx
Rx Price
Quotes Easy Drug
Members
hip price
(Generic)
High Phone
App Price
Low
Phone
App Price
Price
Difference
(High to
Low) Mean All generics
Neptazane
(Methazolami
de) 25mg N.A $58.04 $ 104.49 $ 47.34 $ 53.05 N.A. $ 104.49
$
47.34
$
57.15 $ 95.55
Plavix
(Clopidogrel) 75mg $144.99 $75.82 $ 39.36 $ 149.20 $ 91.08 N.A. $ 149.20
$
39.36
$
109.84 $ 73.86
Actos
(Pioglitazone) 45 mg
$
310.97
$
77.33 $ 79.85 $ 14.61 $ 147.69 N.A. $ 310.97
$
14.61
$
296.36 $ 131.85
Feldene
(Piroxicam) 20mg
$
93.69
$
52.07 $ 60.82 $ 91.51 $ 61.01 N.A. $ 93.69
$
52.07
$
41.62 $ 72.40
Pravachol
(Pravastatin) 20mg
$
10.00
$
10.00 $ 16.60 $ 28.10 $ 46.20 $5.00 $ 46.20 $5.00
$
41.20 $ 24.46
Ranexa (ER
12 h) 500mg $508.47 $365.53 $ 360.53 $ 187.51 $ 156.00 N.A. $508.47
$
156.00
$
352.47 $ 279.60
Risperdal
(Risperidone) 1mg
$
105.10
$
34.41 $ 29.58 $ 34.60 $ 61.78 $15.00 $ 105.10 $15.00
$
90.10 $ 53.21
Singulair
(Montelukast) 10mg $132.99 $63.31 $ 31.87 $ 142.01 $ 75.24 N.A. $ 142.01
$
31.87
$
110.14 $ 66.97
Zyprexa
(Olanzapine) 10mg
$
324.99
$
90.02 $ 120.01 $ 424.47 $ 248.47 N.A. $ 424.47
$
90.02
$
334.45 $ 189.06
Copayments
Table 9B: HEALTH CONNECTOR Rx DRUG COPAYMENTS AFTER
DEDUCTIBLE
DRUG
TIER:
Tier 1
Generic
Drugs
Tier 2
Preferred
Brands
Tier 3
Non-Preferred
Brands
Tier 4
Specialty Drugs
TYPE OF
PLAN:
Bronze $25 $75 $100 $100
Silver $20 $60 $90 $90
Gold $20 $30 $50 $50
Platinum $15 $30 $50 $50
Table 9C: CONNECTORCARE COPAYMENTS
Generics Preferred
Brands
Non-
Preferred
Brands
Specialty Drugs
PLAN TYPE:
Type 1 $1 $3.65 $3.65 $3.65
Types 2A & 2B $10 $20 $40 $40
Types 3A & 3B $12.50 $25 $50 $50
Connector Care Plans are available for those household incomes
at or below 300%FPL .
PET
PET MED WEB SITES
Pet web sites compared with
standard pharmacies
DRUGS Highest Firm
Price
Highest Lowest Firm
Price
Lowest Lowest Firm Price Lowest
Generic Generic all non-pet non-pet
Amitriptyline Walmart $ 12.00 Walmart $ 4.00 Walmart $ 4.00
Cefpodoxime
Proxetil H Warehouse $225.80 1800petsupplies $ 40.20 Walgreens $ 88.35
Digoxin Costco/Walmart $ 69.15 CVS $ 10.97 CVS $ 10.97
Doxycycline
Hyclate Costco $137.61 Costco $ 15.24 Costco $ 15.24
Enalaprilll CVS $ 41.49 petsupplies4less $ 5.70 Costco $ 10.76
Fluoxetine CVS $151.60 Walmart $ 4.00 Walmart $ 4.00
Furosemide CVS $ 14.22 PetcareRx $ 3.60 Walmart $ 4.00
Hydroxyzine HCL 1800 PetMeds $ 24.30 H Warehouse $ 5.00 H Warehouse $ 5.00
Lactulose Solution Walmart $ 30.55 Walmart $ 8.02 Walmart $ 8.02
Levothyroxine H Warehouse $ 23.40 1800 PetMeds $ 3.30 Walmart $ 4.00
Methimazole RiteAid $ 25.99 petsupplies4less $ 8.70 Costco $ 12.03
Methocarbamol CVS $ 15.70 H Warehouse $ 5.00 H Warehouse $ 5.00
Metronidazole Costco $ 36.12 H Warehouse $ 10.08 H Warehouse $ 10.08
Piroxicam RiteAid $123.34 Walmart $ 48.04 Walmart $ 48.04
Prednisone petsupplies4less $ 14.70 H Warehouse $ 5.00 H Warehouse $ 5.00
Spironolactone RiteAid $ 14.85 Walmart $ 4.00 Walmart $ 4.00
Theophylline RiteAid $ 41.69 H Warehouse $ 21.00 H Warehouse $ 21.00
Tramadol CVS $ 21.58 Walmart $ 4.90 Walmart $ 4.90
Transparency and Retail Rx Drug Price Variation
1) Tools that can reveal price information are often used
to facilitate price discrimination. Phone apps facilitate
comparing prices of competing retailers but sellers often
use them to market drugs and offer different price
discounts to various consumers.
2) Retail price variations are due price discrimination,
marketing strategies and differences in insurance
copayments rather than lack of price transparency.
3) The promotion of price transparency is often necessary
but insufficient to reduce retail price variation and anti-
competitive practices.
4) Reducing the cost of obtaining price information could
help lower prices for consumers if drugs were sold
through a regulated exchange. Many proponents of
transparency dislike regulation and will oppose a
regulated exchange even though it would produce optimal
price transparency.

Marc Rodwin, "Pharmaceutical Price Transparency and Consumer Choice: An Empirical Test and Conceptual Choice"

  • 1.
    CAN TRANSPARENCY REDUCE RETAILPHARMACEUTICAL PRICE DISPARITIES OR LOWER COSTS FOR CONSUMERS? Marc A Rodwin, J.D., Ph.D. Suffolk University Law School Transparency in Health and Health Care: Legal and Ethical Possibilities and Limits 2017 Harvard Law School Petrie-Flom Center April 28, 2017
  • 4.
    3 commonly assertedpropositions re Rx transparency 1) Prescription drug prices lack transparency. 2) Lack of price transparency is new and contributes to wide price variations. 3) Increasing transparency is sufficient to reduce price variation and lower prices.
  • 5.
    Better supported alternativepropositions 1) There was little pharmaceutical price transparency in the 1960s due to restrictions on advertising and the lack of technology to facilitate learning prices. These obstacles have since been removed. 1) Variation in retail prescription drug prices in the U.S. has existed since the mid-1960s and persists despite recent increased price transparency. 1) Other factors explain wide prices variation and high prices:
  • 6.
    Other factors explainwide prices variation and high prices: a) Retailers, Pharmaceutical Benefit Managers (PBMs) and manufacturers price discriminate to increase revenue. b) Insurance copayment policies result in some consumers paying more than others for identical medications. c) High transaction costs deter consumers from comparing prices effectively or purchasing medication based on price. d) Wide price variation is due to retailers, PBM and manufacturers marketing strategies and the absence of perfect competition.
  • 7.
    1967. Hastings, GlenE., and Richard Kunnes. "Predicting prescription prices." New England Journal of Medicine 277, no. 12 (1967): 625-628. 1970. What is the price of an Rx Drug? Consumer Reports 35 no. 5 279 (May 1970) 1973. Wertheimer, Albert I. "Pricing pharmaceutical service—art, science or whim." Journal of the American Pharmaceutical Association 13, no. 1 (1973): 11-12, at 11. 1975. Cady, John F., and Alan R. Andreasen. "Price levels, price practices and price discrimination in a retail market for prescription drugs." The Journal of Consumer Affairs (1975): 33-48. 1977. Berki, S. E., J. W. Richard, and H. A. Weeks. "The mysteries of prescription pricing in retail pharmacies." Medical care 15, no. 3 (1977): 241-250. Wertheimer, Albert I. "Pricing pharmaceutical service—art, science or whim." Journal of the American Pharmaceutical Association 13, no. 1 (1973): 11-12, at 11. 1986. Bloom, Bernard S., David J. Wierz, and Mark V. Pauly. "Cost and price of comparable branded and generic pharmaceuticals." JAMA 256, no. 18 (1986): 2523-2530.
  • 8.
    Uninsured 1) Low costgenerics sold at for $4 to $10 for a 30 day supply. • Low cost list varies with pharmacy. 2) Other generics branded drugs sold at many prices by each pharmacy. • In Boston 6 chains, 1 mail order retailer; many independent. Pharmacies. A) List price; B) Membership discount; C) Discounts through phone apps vary with pharmacy and phone app. • Good RX • Well Rx • Rx Price Quotes • Easy Drug 3) Pet med web sites sell human drugs sometimes at lower price than pharmacies. Insured 1)Co-payments vary with market segment and insurer. 2) Copayments vary with which of 3 to 5 copayment tiers the drug is placed. 3) Purchasing drug without insurance from low-price drug list or with discount coupon is sometimes less expensive paying the insurance copayment. 4) Pet med web sites sometimes charge lower prices than standard pharmacies.
  • 9.
  • 10.
    PRESCRIPTION DRUG HIGHEST FIRM LOWEST FIRM 2ND LOWEST FIRM PRICE DIFFERENCE MEAN PRICE Aripiprazole; Abilify Walgreens:$944.09 Costco: $90.47 CVS: $158.81 $68.34 $522.35 Fluticasone: Advair Rite Aid: $330.39 Costco: $150.39 Walmart: $153.16 $2.77 $232.52 Albendazole: Albenza CVS: 5511.92 Costco: $5005.55 Walmart $5253.81 $248.26 $5,380.04 Captopril: Capoten CVS: $81.14 Costco/Walmart: $8.54 Rite Aid: $9.99 $1.45 $26.35 Clomipramine: Anafranil H Warehouse: $333.0 Walgreens: $10 CVS: $106.06 $91.06 $197.20 Duloxetine: Cymbalta Walgreens: $231.99 H Warehouse: $15.75 Walmart: $25.74 $9.99 $109.36 Digoxin: Lanoxin Walmart/ Costco: $69.15 Walgreens: $5 Rite Aid: $10 $4.99 $34.02 Table 5: Summary of Retail Price Variation for 21 Drugs: Highest price, lowest price, 2nd-lowest price, $ difference between lowest and 2nd lowest price, and mean price (Part 1)
  • 11.
    Prescription Drug HIGHEST FIRM LOWEST FIRM 2ND LOWEST FIRM PRICE DIFFERENCE MEAN PRICE Doxycycline: Monohydrate Monodox Walmart: $124.54H Warehouse: $14.98 Walgreens: $15 $0.02 $56.02 Doxycycline Hyclate: Vibramycin CVS: $182.81 Rite Aid: $9.99 Walgreens:$15 $5.25 $69.67 Erythromycin: Erythrocin H Warehouse: $660.90 Costco: $61.19 CVS: $183.29 $122.10 $431.94 Atorvastatin: Lipitor Rite Aid: $149.99 H Warehouse: $6.30 Costco: $9.95 $3.65 $64.12 Metformin: Glucophage Walmart: $29.06 Walmart: $4 Walgreens/ H Warehouse:$5 $1 $10.33 Methazolamid e: Neptazane CVS: $185.78 CVS: $31.36 Walgreens: $47.34 $15.98 $95.55 Clopidogrel: Plavix Rite Aid: $152.99 H Warehouse: $7.90 Walmart: $18.48 $10.58 $73.86 Table 5: Summary of Retail Price Variation for 21 Drugs: Highest price, lowest price, 2nd-lowest price, $ difference between lowest and 2nd lowest price, and mean price (Part 2)
  • 12.
    PRESCRIPTI ON DRUG HIGHEST FIRM LOWEST FIRM 2ND LOWEST FIRM PRICE DIFFERENCE MEAN PRICE Pioglitazone: Actos Rite Aid: $347.99 HWarehouse: $6.95 Costco: $14.57 $7.62 $131.85 Piroxicam: Feldene Rite Aid: $123.34 Walmart: $48.04 CVS: $51.16 $3.12 $72.40 Pravastatin: Pravachol CVS: $65.31 Walgreens: $5 Rite Aid: $9.99 $4.99 $23.75 Amitriptyline: Ranexa Walgreens: $508.47 Costco : $154.01 Walmart: $154.06 $0.05 $279.60 Risperidone: Risperdal Rite Aid: $119.99 Costco: $8.80 Walgreens: $15 $6.20 $53.21 Montelukast: Singulair Rite Aid: $169.99 H Warehouse: $8 Costco: $11.27 $3.27 $66.97 Olanzapine: Zyprexa CVS: $436.99 H Warehouse: $11.85 Costco: $12.40 $0.55 $189.06 Table 5: Summary of Retail Price Variation for 21 Drugs: Highest price, lowest price, 2nd-lowest price, $ difference between lowest and 2nd lowest price, and mean price (Part 3)
  • 13.
    PHARMACY Lowest $amount between highest and lowest price for a single medication Highest $ amount between highest and lowest price for a single medication $ amount between lowest and highest price difference Mean savings when purchasing at lowest price* Health Warehouse $0 (Aripiprazole Digoxin, Erythromycin, Piroxicam, Risperidone. No price difference $14.12 (Doxycycline) $14.12 $3.47 Costco $1.85 (Metformin) $590.11 (Aripiprazole) $588.26 $150.98 CVS $12.11 (Metformin) $731.18 (Aripiprazole) $719.07 $172.18 Rite Aid $6.03 (Metformin) $507.06 (Aripiprazole) $501.03 $145.11 Walgreens $10.07 (Metformin) $674.93 (Aripiprazole) $664.86 $149.64 Walmart $10.92 (Methazolamide) $232.70 (Olanzapine) $221.78 $91.58 Table 6: Range of prices offered within a single pharmacy: Lowest $ difference between high and low price; highest $ difference between high and low price; Mean saving by purchasing drug at lowest price.
  • 14.
  • 15.
    Table 7A CVSGeneric Drug Pricing Pharmacy/Plan Name Dose Listed Price Generic GoodRX Coupon Well Rx Rx Price Quotes Easy Drug Caremark Price (Generic) Caremark Price (Brand) - Mail service Price Difference (High to Low) Mean All generics Abilify (Aripiprazole) 2mg $ 889.99 $ 158.81 $ 681.82 $ 844.85 $ 584.49 $ 299.44 $ 295.77 $ 731.18 $ 522.35 Advair 100/50mcg N.A. N.A. N.A. N.A. N.A. N.A. N.A. N.A. N.A. Albenza (Albendazole) 400mg N.A. N.A N.A N.A N.A N.A. N.A. N.A N.A. Capoten (Captopril) 12.5mg $ 27.19 $ 19.91 $ 27.19 $ 11.92 $ 34.55 $ 81.14 $ 72.56 $ 69.22 $ 26.35 Anafranil capsules (Clomipramine) 50mg $ 266.99 $ 106.06 $ 243.58 $ 121.00 $ 208.85 $ 281.25 N.A. $ 175.19 $ 197.20 Cymbalta DR capsule (duloxetine) 20mg $ 195.99 $ 41.85 $ 96.45 $ 189.41 $ 132.47 $ 71.88 $ 63.10 $ 154.14 $ 109.36 Lanoxin (Digoxin) .125mg $ 39.39 $ 10.97 $ 33.49 $ 12.14 $ 47.90 $ 49.30 $ 29.47 $ 38.33 $ 34.02 Monodox (Doxycycline) 100mg $ 56.59 $ 33.27 $ 73.32 $ 44.14 $ 95.07 $ 36.91 $ 28.00 $ 67.07 $ 56.02 Doryx (Doxycycline hyclate) 100mg $ 89.59 $ 45.70 $ 76.80 $ 46.42 $ 106.08 $ 182.81 $ 80.87 $ 137.11 $ 69.67 Ery-Tab (Erythromycin) 500mg N.A. $ 289.64 $ 497.99 $ 183.29 $ 444.40 $ 327.24 $ 439.50 $ 314.70 $ 431.94 Lipitor (atorvastatin) 20mg $ 134.99 $ 19.11 $ 69.98 $ 90.08 $ 110.31 $ 60.96 $ 51.99 $ 91.20 $ 64.12 Glucophage (Metformin) 500mg $ 11.99 $ 12.81 $ 11.33 $ 13.05 $ 19.19 $ 17.10 $ 7.08 $ 12.11 $ 10.33
  • 16.
    Table 7A CVSGeneric Drug Pricing continued Pharmacy/Plan Name Dose Listed Price Generic GoodRX Coupon Price Well Rx Rx Price Quotes Easy Drug Caremark Price (Generic) Caremark Price (Brand) - Mail service Price Difference (High to Low) Mean All generics Neptazane (Methazolamide) 25mg $ 105.99 **48.49 (50mg) $ 87.95 $ 31.36 $ 75.46 $ 185.78 $ 179.55 $ 154.42 $ 95.55 Plavix (clopidogrel) 75mg $ 141.99 $ 85.15 $ 80.11 $ 112.01 $ 131.80 $ 73.11 $ 64.35 $ 77.64 $ 73.86 Actos (Pioglitazone) 45 mg $ 305.99 $ 25.92 $ 251.46 $ 182.78 $ 215.67 $ 115.03 $ 107.22 $ 280.07 $ 131.85 Feldene (Piroxicam) 20mg $ 79.99 $ 51.30 $ 51.16 $ 53.86 $ 87.25 $ 75.10 $ 66.39 $ 36.09 $ 72.40 Pravachol (Pravastatin) 20mg $ 33.99 $ 22.59 $ 25.93 $ 36.87 $ 65.31 $ 37.49 $ 27.93 $ 42.72 $ 24.46 Ranexa (ER 12 h) 500mg $ 424.79 $ 364.53 $ 359.53 $ 188.26 $ 155.63 N.A. N.A. $ 60.26 $ 279.60 Risperdal (Risperidone) 1mg $ 93.59 $ 19.14 $ 48.91 $ 76.73 $ 88.40 $ 79.84 $ 71.24 $ 74.45 $ 53.21 Singulair (Montelukast) 10mg $ 128.99 $ 22.48 $ 68.13 $ 95.26 $ 108.33 $ 69.88 $ 61.05 $ 106.51 $ 66.97 Zyprexa (Olanzapine) 10mg $ 436.99 $ 27.35 $ 96.30 $ 309.14 $ 364.98 $ 189.65 $ 183.51 $ 409.64 $ 189.06 average: $ 159.58
  • 17.
    Table 7B RiteAidGeneric Drug Pricing Pharmacy/ Plan Name Dose Listed Price Generic GoodRX Coupon Price Well Rx Rx Price Quotes Easy Drug Membership price (Generic) High Phone App Price Low Phone App Price Difference high to low Abilify (Aripiprazole) 2mg $ 899.99 $ 944.07 $ 437.01 $ 844.35 $ 439.99 N.A. $ 944.07 $ 437.01 $ 507.06 Advair 100/50mcg N.A N.A N.A N.A N.A N.A. N.A. N.A. N.A. Albenza (Albendazole) 400mg N.A N.A N.A N.A N.A N.A. N.A. N.A. N.A. Capoten (Captopril) 12.5mg $ 44.99 $ 9.99 $ 25.05 $ 28.44 $ 27.54 $ 9.99 $ 44.99 $ 9.99 $ 35.00 Anafranil capsules (Clomipramine) 50mg $ 308.99 $ 142.40 $ 155.76 $ 299.67 $ 158.26 N.A. $ 308.99 $ 142.40 $ 166.59 Cymbalta DR capsule (duloxetine) 20mg $ 199.99 $ 91.40 $ 98.48 $ 188.91 $ 100.98 N.A. $ 199.99 $ 91.40 $ 108.59 Lanoxin (Digoxin) .125mg $ 9.99 $ 9.99 $ 35.05 $ 57.41 $ 37.55 $ 9.99 $ 57.41 $ 9.99 $ 47.42 Monodox (Doxycycline) 100mg $ 99.99 $ 81.26 $ 70.43 $ 46.17 $ 72.93 N.A. $ 99.99 $ 46.17 $ 53.82 Doryx (Doxycycline Hyclate) 100mg $ 110.09 $ 81.26 $ 78.68 $ 41.31 $ 81.18 $ 9.99 $ 110.09 $ 9.99 $ 100.10 Ery-Tab (Erythromycin) 500mg N.A. $ 236.71 $ 516.99 $ 504.78 $ 439.57 N.A. $ 516.99 $ 236.71 $ 280.28 Lipitor (Atorvastatin) 20mg $ 149.99 $ 36.09 $ 81.94 $ 111.56 $ 84.36 N.A. $ 149.99 $ 36.09 $ 113.90 Glucophage (Metformin) 500mg $ 9.99 $ 9.99 $ 13.50 $ 10.33 $ 16.02 $ 9.99 $ 16.02 $ 9.99 $ 6.03
  • 18.
    Table 7 BRiteAid Generic Drug Pricing continued Pharmacy/ Plan Name Dose Listed Price Generic GoodRX Coupon Price Well Rx Rx Price Quotes Easy Drug Members hip price (Generic) High Phone App Price Low Phone App Price Difference high to low Neptazane (Methazolami de) 25mg $ 114.99 $ 130.09 $ 55.72 $ 83.38 $ 58.22 N.A. $ 130.09 $ 55.72 $ 74.37 Plavix (Clopidogrel) 75mg $ 152.99 $ 21.16 $ 97.97 $ 91.76 $ 100.47 N.A. $ 152.99 $ 91.03 $ 61.96 Actos (Pioglitazone) 45 mg $ 347.99 $ 146.91 $ 155.88 $ 21.16 $ 163.38 N.A. $ 347.99 $ 21.16 $ 326.83 Feldene (Piroxicam) 20mg $ 85.99 $ 61.34 $ 64.57 $ 123.34 $ 67.07 N.A. $ 123.34 $ 61.34 $ 62.00 Pravachol (Pravastatin) 20mg $ 9.99 $ 9.99 $ 48.10 $ 20.78 $ 50.61 $ 30.00 $ 50.61 $ 9.99 $ 40.62 Ranexa (ER 12 h) 500m g $ 439.99 $ 358.03 $ 363.53 $ 187.51 $ 154.76 N.A. $ 439.99 $ 154.76 $ 285.23 Risperdal (Risperidone) 1mg $ 119.99 $ 62.12 $ 65.45 $ 25.69 $ 67.93 N.A. $ 119.99 $ 25.69 $ 94.30 Singulair (Montelukast) 10mg $ 169.99 $ 75.39 $ 80.28 $ 39.88 $ 82.87 N.A. $ 169.99 $ 39.88 $ 130.11 Zyprexa (Olanzapine) 10mg $ 306.53 $ 246.48 $ 272.86 $ 19.13 $ 275.36 N.A. $ 306.53 $ 19.13 $ 287.40
  • 19.
    Table 7 C:Walgreens Generic Drug Pricing Pharmacy/Plan Name Dose Listed Price Generic GoodRX Well Rx Rx Price Quotes Easy Drug Membership price High Phone App Price Low Phone App Price Price Difference (High to Low) Mean All generics Abilify (Aripiprazole) 2mg $ 944.09 $ 317.25 $ 269.16 $ 844.10 $ 396.64 N.A. $ 944.09 $ 269.16 $ 674.93 $ 522.35 Advair 100/50m cg N.A N.A. N.A. N.A. N.A. N.A. N.A. N.A. N.A. N.A. Albenza (Albendazole) 400mg N.A N.A. N.A. N.A. N.A. N.A. N.A. N.A. N.A N.A. Capoten (Captopril) 12.5mg $ 29.89 $ 15.35 $ 29.36 $ 13.22 $ 25.43 $10.00 $ 29.89 $10.00 $ 19.89 $ 26.35 Anafranil capsules (Clomipramine) 50mg $ 259.69 $ 32.36 $ 234.05 $ 32.92 $ 143.09 $15.00 $ 259.69 $ 147.31 $ 112.38 $ 197.20 Cymbalta DR capsule (Duloxetine) 20mg $ 231.99 $ 76.18 $ 74.94 $ 188.66 $ 91.53 N.A. $ 231.99 $ 74.94 $ 157.05 $ 109.36 Lanoxin (Digoxin) .125mg $ 42.95 $ 15.64 $ 31.22 $ 14.58 $ 34.45 $5.00 $ 42.95 $5.00 $ 37.95 $ 34.02 Monodox (Doxycycline) 100mg $ 58.79 $ 32.90 $ 57.45 $ 50.94 $ 66.28 $15.00 $ 66.28 $15.00 $ 51.28 $ 56.02 Doryx (Doxycycline Hyclate) 100mg $ 95.99 $ 52.23 $ 51.13 $ 57.83 $ 73.72 $15.00 $ 95.99 $15.00 $ 80.99 $ 69.67 Ery-Tab (Erythromycin) 500mg $531.53 N.A. $ 513.99 $ 504.53 $ 443.19 N.A. $531.53 $ 443.19 $ 88.34 $ 431.94 Lipitor (Atorvastatin) 20mg $ 134.99 $ 58.00 $ 36.60 $ 138.32 $ 76.57 N.A. $ 138.32 $ 36.60 $ 101.72 $ 64.12 Glucophage (Metformin) 500mg $5.00 $5.00 $ 7.32 $ 10.28 $ 15.07 $5.00 $ 15.07 $5.00 $ 10.07 $ 10.33
  • 20.
    Table 7C WalgreensGeneric Drug Pricing continued Pharmacy/ Plan Name Dose Listed Price Generic GoodRX Coupon Well Rx Rx Price Quotes Easy Drug Members hip price (Generic) High Phone App Price Low Phone App Price Price Difference (High to Low) Mean All generics Neptazane (Methazolami de) 25mg N.A $58.04 $ 104.49 $ 47.34 $ 53.05 N.A. $ 104.49 $ 47.34 $ 57.15 $ 95.55 Plavix (Clopidogrel) 75mg $144.99 $75.82 $ 39.36 $ 149.20 $ 91.08 N.A. $ 149.20 $ 39.36 $ 109.84 $ 73.86 Actos (Pioglitazone) 45 mg $ 310.97 $ 77.33 $ 79.85 $ 14.61 $ 147.69 N.A. $ 310.97 $ 14.61 $ 296.36 $ 131.85 Feldene (Piroxicam) 20mg $ 93.69 $ 52.07 $ 60.82 $ 91.51 $ 61.01 N.A. $ 93.69 $ 52.07 $ 41.62 $ 72.40 Pravachol (Pravastatin) 20mg $ 10.00 $ 10.00 $ 16.60 $ 28.10 $ 46.20 $5.00 $ 46.20 $5.00 $ 41.20 $ 24.46 Ranexa (ER 12 h) 500mg $508.47 $365.53 $ 360.53 $ 187.51 $ 156.00 N.A. $508.47 $ 156.00 $ 352.47 $ 279.60 Risperdal (Risperidone) 1mg $ 105.10 $ 34.41 $ 29.58 $ 34.60 $ 61.78 $15.00 $ 105.10 $15.00 $ 90.10 $ 53.21 Singulair (Montelukast) 10mg $132.99 $63.31 $ 31.87 $ 142.01 $ 75.24 N.A. $ 142.01 $ 31.87 $ 110.14 $ 66.97 Zyprexa (Olanzapine) 10mg $ 324.99 $ 90.02 $ 120.01 $ 424.47 $ 248.47 N.A. $ 424.47 $ 90.02 $ 334.45 $ 189.06
  • 21.
  • 22.
    Table 9B: HEALTHCONNECTOR Rx DRUG COPAYMENTS AFTER DEDUCTIBLE DRUG TIER: Tier 1 Generic Drugs Tier 2 Preferred Brands Tier 3 Non-Preferred Brands Tier 4 Specialty Drugs TYPE OF PLAN: Bronze $25 $75 $100 $100 Silver $20 $60 $90 $90 Gold $20 $30 $50 $50 Platinum $15 $30 $50 $50
  • 23.
    Table 9C: CONNECTORCARECOPAYMENTS Generics Preferred Brands Non- Preferred Brands Specialty Drugs PLAN TYPE: Type 1 $1 $3.65 $3.65 $3.65 Types 2A & 2B $10 $20 $40 $40 Types 3A & 3B $12.50 $25 $50 $50 Connector Care Plans are available for those household incomes at or below 300%FPL .
  • 24.
  • 25.
    Pet web sitescompared with standard pharmacies DRUGS Highest Firm Price Highest Lowest Firm Price Lowest Lowest Firm Price Lowest Generic Generic all non-pet non-pet Amitriptyline Walmart $ 12.00 Walmart $ 4.00 Walmart $ 4.00 Cefpodoxime Proxetil H Warehouse $225.80 1800petsupplies $ 40.20 Walgreens $ 88.35 Digoxin Costco/Walmart $ 69.15 CVS $ 10.97 CVS $ 10.97 Doxycycline Hyclate Costco $137.61 Costco $ 15.24 Costco $ 15.24 Enalaprilll CVS $ 41.49 petsupplies4less $ 5.70 Costco $ 10.76 Fluoxetine CVS $151.60 Walmart $ 4.00 Walmart $ 4.00 Furosemide CVS $ 14.22 PetcareRx $ 3.60 Walmart $ 4.00 Hydroxyzine HCL 1800 PetMeds $ 24.30 H Warehouse $ 5.00 H Warehouse $ 5.00 Lactulose Solution Walmart $ 30.55 Walmart $ 8.02 Walmart $ 8.02 Levothyroxine H Warehouse $ 23.40 1800 PetMeds $ 3.30 Walmart $ 4.00 Methimazole RiteAid $ 25.99 petsupplies4less $ 8.70 Costco $ 12.03 Methocarbamol CVS $ 15.70 H Warehouse $ 5.00 H Warehouse $ 5.00 Metronidazole Costco $ 36.12 H Warehouse $ 10.08 H Warehouse $ 10.08 Piroxicam RiteAid $123.34 Walmart $ 48.04 Walmart $ 48.04 Prednisone petsupplies4less $ 14.70 H Warehouse $ 5.00 H Warehouse $ 5.00 Spironolactone RiteAid $ 14.85 Walmart $ 4.00 Walmart $ 4.00 Theophylline RiteAid $ 41.69 H Warehouse $ 21.00 H Warehouse $ 21.00 Tramadol CVS $ 21.58 Walmart $ 4.90 Walmart $ 4.90
  • 26.
    Transparency and RetailRx Drug Price Variation 1) Tools that can reveal price information are often used to facilitate price discrimination. Phone apps facilitate comparing prices of competing retailers but sellers often use them to market drugs and offer different price discounts to various consumers. 2) Retail price variations are due price discrimination, marketing strategies and differences in insurance copayments rather than lack of price transparency.
  • 27.
    3) The promotionof price transparency is often necessary but insufficient to reduce retail price variation and anti- competitive practices. 4) Reducing the cost of obtaining price information could help lower prices for consumers if drugs were sold through a regulated exchange. Many proponents of transparency dislike regulation and will oppose a regulated exchange even though it would produce optimal price transparency.