In 2013, pharmacy benefits manager Express Scripts estimated that the United States wasted $55.8 billion on high-priced medications when more affordable drugs could have been used instead. Expensive is simply not always better.
Here are nine prescription drugs that are usually very expensive, even with insurance. All of them have cheaper alternatives that work just as well.
1) Vimovo
One tablet of Vimovo contains 500 mg of the anti-inflammatory drug,naproxen, and 20 mg of esomeprazole, the same ingredient in Nexium used to treat acid reflux. Here’s an idea: Instead of paying thousands of dollars for 60 tablets of Vimovo, get 60 tablets of naproxen 500 mg and 60 tablets of esomeprazole 20 mg, separately. If you also pay with GoodRx coupons, you could be looking at less than $50 for your total cost.
2) Dexilant
Dexilant is a very expensive brand-name proton pump inhibitor used to treat acid reflux. However, studies show that Dexilant works practically as well as cheaper proton pump inhibitors out there. If your doctor prescribes you Dexilant, do yourself a favor and ask about lansoprazole or pantoprazole instead.
3) Olmesartan (generic Benicar)
Used for high blood pressure, olmesartan is an expensive generic angiotensin receptor blocker (ARB). Olmesartan is no better than cheaper ARBs like valsartan and losartan for treating hypertension, which cost two to four times less. Plus, olmesartan can cause severe chronic diarrhea and weight loss for months to years after starting the drug. Hmmm.
4) Vytorin
Vytorin is a mixture of cholesterol-lowering medications simvastatin and Zetia (ezetimibe). Unless you’ve recently had a heart attack and need extreme therapy, you don’t need to waste money on Vytorin. Here’s why: Statins like simvastatin are the first choice in virtually all patients with high cholesterol to lower heart disease risk. People have been paying for Vytorin for years, even though it’s still unclear whether the combo of simvastatin and Zetia is better than simvastatin alone for preventing heart attacks. A recent study showed that Vytorin could help after a heart attack, but in other cases, you’re better off sticking with just the simvastatin part and not bothering with the combo.
5) Bystolic
There is no evidence the expensive, brand-name blood pressure drug, Bystolic, is better than two similar generic options, metoprolol or carvedilol. All three drugs are equally effective at treating high blood pressure and protecting heart failure patients, so there is no reason to pay more for Bystolic.
6) Zafirlukast
Zafirlukast is a medication used to prevent and treat asthma symptoms. It works similarly to montelukast, although zafirlukast costs about 25% more based on monthly cash price. Furthermore, zafirlukast requires two doses a day and has time limitations around meals, whereas montelukast is taken once daily at any time.
7) Celecoxib
Celecoxib, used to treat osteoarthritis and rheumatoid arthritis, is an expensive generic drug with a cash price of around $200 for a typical monthly prescription. Fortunately, there’s meloxicam, which has a cash price of $30 for a month’s supply and works similarly to celecoxib.
8) Desvenlafaxine
Desvenlafaxine is used to treat both fibromyalgia and depression. At a monthly cash price of around $300, desvenlafaxine is expensive even though it’s a generic. For fibromyalgia, duloxetine works just as well as desvenlafaxine and is cheaper, with a monthly cash price of around $200. For depression, you can either try duloxetine or another generic, venlafaxine (around $100 for a typical monthly prescription), before paying for Pristiq.
9) Olopatadine
Olopatadine antihistamine eye drops are used to treat red, itchy eyes from allergies, but even as a generic, they can cost around $150 for a typical monthly prescription. A good alternative might be azelastine, which costs half as much as olopatadine based on cash price. While olopatadine has the advantage of once daily dosing compared to twice daily dosing with azelastine, is it worth the cost?
Dr O.
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