What pharmacies paid for omeprazole, pantoprazole and famotidine

On April 1, 2020, FDA asked manufacturers to withdraw all prescription and over-the-counter ranitidine¹ from the US market, after its testing showed that levels of the impurity NDMA in the heartburn drug could rise over time and with heat. In the same announcement, FDA said its testing had not found NDMA in famotidine, omeprazole or several other acid reducers.

Within a year, the pharmacy cost of a prescription famotidine 20 mg tablet had jumped. It was 3.4 cents in April 2020 and 5.8 cents in January 2021, a 68 percent rise, according to GxRadar's analysis of the federal National Average Drug Acquisition Cost (NADAC) files³. Then it came back down. In October 2026 the latest files⁵ put it at 2.85 cents, below where it started in 2013. That is about 31 percent less than five years earlier and about 21 percent less than in January 2014, when it was 3.6 cents.

Famotidine's spike is the most dramatic episode in the price records of the three acid reducers GxRadar tracks. The other two, the proton pump inhibitors omeprazole and pantoprazole, cost pharmacies less than half what they did in 2013. This piece compares the three series through October 2026, explains a correction to how we calculate famotidine, and sets the prices against Medicare prescription and FDA approval data.

Three drugs, 13 years

Figures are GxRadar's monthly median of weekly NADAC per-unit rates for generic-classified products: omeprazole delayed-release 20 mg capsules, pantoprazole delayed-release 40 mg tablets and famotidine 20 mg tablets. The first row is November 2013, when the NADAC series begins²; the rest are Octobers. Famotidine figures use prescription products only, for reasons explained below.

Omeprazole peaked at 8.8 cents in February 2014 and reached a low of 2.8 cents in August 2026. Pantoprazole peaked later, at 13.1 cents in April 2015, and had its sharpest fall at the end of 2024, from 5.2 cents in October to 3.7 cents in December, according to the 2024 NADAC files⁴. CMS began calculating monthly generic rates as a three-month moving average with its December 2024 updates, according to its methodology⁶, so later readings are smoother.

At October 2026 rates, 365 units cost a pharmacy $10.93 for omeprazole, $13.23 for pantoprazole and $10.41 for prescription famotidine. Those are different drugs at different strengths, used in different ways, and the figures say nothing about how they compare as treatments. Which acid reducer fits a person is a question for a prescriber or pharmacist.

Famotidine after the ranitidine withdrawal

Monthly figures show when the rise came. Most of it happened between October 2020 and January 2021, six months after FDA's ranitidine request, and the figure was back under 3.5 cents by January 2022.

Prescription volume moved too. Medicare Part D claims for generic famotidine rose from 8.7 million in 2020 to 14.0 million in 2024, a 62 percent increase, according to CMS's Medicare Part D Spending by Drug⁸ data. CMS's methodology⁹ says over-the-counter drugs are excluded from those figures. The 2024 data list 33 manufacturers.

New supply followed. GxRadar counted abbreviated new drug applications (ANDAs) covering a famotidine 20 mg tablet in FDA's Drugs@FDA data¹⁰. FDA approved 15 from 2021 through 2025, nine now marketed as prescription products and six as over-the-counter, against two in the three years from 2014 through 2016. Whether the 2020 price jump came from demand shifting after the withdrawal, from supply limits, or from both, the NADAC data cannot say. They show timing only.

A correction to our famotidine figures

Famotidine is sold both by prescription and over the counter; FDA approved an over-the-counter version in 1995, according to the Drugs@FDA record¹⁰ for that application. CMS sets separate NADAC rates for the two. Its methodology states that "NADAC rates for legend drugs are calculated only from costs for legend drug NDCs," and over-the-counter rates only from over-the-counter products.

Starting in October 2020, the NADAC files list over-the-counter famotidine 20 mg tablets under the same product description as prescription ones, with an OTC flag. Their monthly rate has ranged from 13.6 to 16.5 cents a tablet, about five times the prescription rate in October 2026. As more over-the-counter products were added, a simple average across every row with that description drifted up even as the prescription rate fell.

That combined average makes famotidine look 51 percent more expensive than in November 2013. The prescription rate alone is 15 percent cheaper. Some earlier GxRadar figures for famotidine used the combined average. This article uses the prescription rate, which is the one comparable with the other drugs in our basket. Our explainer on what NADAC measures covers the survey's structure, and how NADAC is calculated goes into the rate groups.

The two proton pump inhibitors

Both omeprazole and pantoprazole had been generic for years before the NADAC series began. FDA's records show the first omeprazole ANDA covering the 20 mg capsule approved on Nov. 1, 2002. For pantoprazole, the first ANDA for the 40 mg tablet, ANDA 077056¹⁰, was approved on Aug. 2, 2007, and seven more followed in 2011, four of them on Jan. 19. GxRadar's count of Drugs@FDA data shows 17 ANDAs covering the omeprazole 20 mg capsule, 14 still marketed, and 20 covering the pantoprazole 40 mg tablet, 13 still marketed.

Medicare use has gone in different directions. Generic omeprazole claims held at about 28 million a year from 2020 to 2024, while generic pantoprazole claims rose 29 percent, from 19.9 million to 25.6 million. The 2024 Part D data list 15 manufacturers for generic omeprazole and 36 for pantoprazole. For how competition tends to move these numbers, see why generic prices fall as competitors enter; for the wider price trend, the long deflation of generic prices.

What the numbers leave out

NADAC reflects invoice prices that a random sample of chain and independent retail pharmacies report to CMS. It excludes discounts not shown on the invoice, purchases under the 340B program and the dispensing fee, and it says nothing about shelf prices for over-the-counter products or what an insured patient pays. The price history page carries all three series, and our guide to talking to a pharmacist about price lists questions people commonly ask at the counter.

CMS posts its next monthly NADAC file on Monday, Nov. 16, 2026, the first Monday on or after the 15th, according to the NADAC page on Medicaid.gov⁷. Prescription famotidine was at 2.85 cents in October, about a seventh of a cent above its series low of 2.71 cents in December 2024.