HealthDay News — According to a research letter published in JAMA Internal Medicine, some patients may not be able to afford to fill all of their prescriptions because cash prices of generic medications to treat heart failure vary so widely.

In a telephone survey, the researchers gathered drug prices from 175 pharmacies in eastern Missouri and neighboring Illinois. The median income in the study areas was $53,000 a year. The study focused on digoxin, lisinopril and carvedilol.

Digoxin was consistently the most expensive, with median prices of $40 and $115 for 30- and 90-day supplies, respectively, regardless of the dosage. Median prices for high-dose versions of lisinopril and carvedilol were about the same: around $14 for a 30-day supply.

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For all 3 drugs, the median price for a month’s supply was nearly $68 for low-dose versions and $71 for high-dose versions. The cost for all 3 drugs went as high as $257 for the lower doses and nearly $400 for the higher doses for a month’s supply. Only 1 in 3 major chains had consistent pricing across all its retail stores.

The wide range of prices was unrelated to the drug dose or duration of therapy, the area where the pharmacy does business, whether it was a chain or independent pharmacy or median income in pharmacy ZIP codes, the researchers noted.

“There may be different reasons for different pricing practices, but this clearly needs more attention because this is going to have a direct effect on patients,” lead author Paul Hauptman, MD, professor of medicine and assistant dean at the Saint Louis University School of Medicine, told HealthDay.


Hauptman PJ, Goff ZD, Vidic A, Chibnall JT, Bleske BE. Variability in Retail Pricing of Generic Drugs for Heart Failure. JAMA Intern Med. Published online November 15, 2016. doi:10.1001/jamainternmed.2016.6955.

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