April 28, 2017 Transparency is a relatively new concept to the world of health and health care, considering that just a few short decades ago we were still in the throes of a “doctor-knows-best” model. Today, however, transparency is found on almost every short list of solutions to a variety of health policy problems, ranging from conflicts of interest to rising drug costs to promoting efficient use of health care resources, and more. Doctors are now expected to be transparent about patient diagnoses and treatment options, hospitals are expected to be transparent about error rates, insurers about policy limitations, companies about prices, researchers about data, and policymakers about priorities and rationales for health policy intervention. But a number of important legal and ethical questions remain. For example, what exactly does transparency mean in the context of health, who has a responsibility to be transparent and to whom, what legal mechanisms are there to promote transparency, and what legal protections are needed for things like privacy, intellectual property, and the like? More specifically, when can transparency improve health and health care, and when is it likely to be nothing more than platitude? This conference aimed to: (1) identify the various thematic roles transparency has been called on to play in American health policy, and why it has emerged in these spaces; (2) understand when, where, how, and why transparency may be a useful policy tool in relation to health and health care, what it can realistically be expected to achieve, and when it is unlikely to be successful, including limits on how patients and consumers utilize information even when we have transparency; (3) assess the legal and ethical issues raised by transparency in health and health care, including obstacles and opportunities; (4) learn from comparative examples of transparency, both in other sectors and outside the United States. In sum, we hope to reach better understandings of this health policy buzzword so that transparency can be utilized as a solution to pressing health policy issues where appropriate, while recognizing its true limitations. Learn more on our website: http://petrieflom.law.harvard.edu/events/details/2017-annual-conference

1. 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

4. 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.

5. 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:

6. 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.

7. 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.

8. 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.

9. 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

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: $124.54 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)

12. 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)

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. Price Variation
within one Pharmacy

15. 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

16. 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

17. 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

18. 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

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 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

21. Copayments

22. 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

23. 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 .

24. PET
PET MED WEB SITES

25. 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

26. 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.

27. 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.