The generics that cost pharmacies more than they did in 2014

In January 2014, retail pharmacies paid an average of about 1 cent for a generic 40 mg furosemide tablet, according to the federal government's weekly NADAC drug cost files². In October 2026 they paid 2.9 cents, according to the 2026 files⁵. That is about 2.8 times as much.

Furosemide, a diuretic sold as a generic for decades, is the clearest case in GxRadar's 47-drug price basket. It is not the only one. Of the 43 drugs with a January 2014 price, seven cost pharmacies more in October 2026: furosemide, warfarin, glipizide, trazodone, allopurinol, amoxicillin and cephalexin. Measured against October 2021, three of the 47 cost more: simvastatin, citalopram and amoxicillin.

Those are exceptions. The median drug in the basket cost 43 percent less in October 2026 than in January 2014 and 26 percent less than five years earlier, and GxRadar's generic price index stood at 47.4 (January 2014 = 100), down about 53 percent. But a generic that gets more expensive is the case that surprises patients and pharmacists, and the numbers show the direction is not fixed. GxRadar's analysis of CMS NADAC files through October 2026 sets the drugs that rose against FDA's shortage records for the same molecules. It stops short of naming a cause for any one increase.

Which drugs cost more, and by how much

We compared each drug's October 2026 figure with two baselines: its January 2014 figure, the base month of our price index, and its October 2021 figure, exactly five years earlier.

Each monthly figure is GxRadar's median of the weekly NADAC per-unit rate for generic-classified products of that drug and strength. Four drugs in the basket (rosuvastatin, valsartan, duloxetine and tadalafil) had no generic price in January 2014 and are left out of the first comparison. None of the figures is adjusted for inflation. The table shows every drug that rose on either measure, plus famotidine and digoxin for contrast.

In absolute terms the amounts are small. Furosemide's rise is 1.9 cents per tablet, or about $6.79 more for 365 tablets. Trazodone's is under a cent.

For most of these drugs, the two baselines tell different stories. Furosemide, trazodone, cephalexin, warfarin, glipizide and allopurinol are above their January 2014 levels but below where they were five years ago. Amoxicillin is above both. Simvastatin and citalopram are up since 2021 while still below their 2014 levels.

Furosemide's step up in 2017

Furosemide did not drift up. It jumped. The monthly figure never went above 1.6 cents from November 2013 through April 2017. Between May and November 2017 it climbed from 1.9 cents to 3.6 cents, its highest month, according to the 2017 NADAC files⁴. Since January 2018 it has stayed between 2.7 and 3.5 cents.

FDA's shortage records do not list furosemide tablets. As of Oct. 30, 2026, the openFDA drug shortages data⁷ carried three furosemide entries. Furosemide injection has been listed as a current shortage since April 7, 2020, with reasons that vary by presentation, including increased demand and manufacturing problems. Furosemide oral solution has been listed since March 31, 2026. A separate furosemide injection entry, posted April 28, 2026, is marked "To Be Discontinued." Those are different products from the oral tablet, and none of the records says anything about tablet prices.

Trazodone, warfarin, allopurinol and two antibiotics

Trazodone 50 mg rose in late 2015. The tablet cost 2.7 cents in September 2015 and 5.3 cents in November, and it peaked at 5.9 cents in April 2016, according to the 2016 files³. It has fallen most years since, to 3.0 cents in October 2026, still 34 percent above January 2014.

Warfarin and allopurinol both spiked in late 2014 and have given back nearly all of it. Warfarin 5 mg cost 8.2 cents in January 2014, 18.4 cents by November and peaked at 20.7 cents in April 2015. Allopurinol 100 mg held near 3 cents through August 2014 and reached 17.2 cents in December, according to the 2014 files², then peaked at 19.3 cents in September 2015. In October 2026 warfarin was 9 percent above its January 2014 price and allopurinol 5 percent above, though allopurinol fell 48 percent in the last five years alone. FDA's shortage data carry one allopurinol tablet entry, posted Feb. 19, 2026, with the status "To Be Discontinued," a category GxRadar explains in its piece on discontinuation entries. Glipizide moved within a narrow band, peaking at 3.7 cents in February 2022.

Famotidine 20 mg shows a spike that unwound. Counting prescription tablets only, with over-the-counter packages excluded, the price climbed from 3.8 cents in September 2020 to 5.8 cents in January 2021, its series high. By October 2026 it was 2.9 cents, about 31 percent below October 2021 and 21 percent below January 2014. Our look at acid reducer prices sets it beside omeprazole and pantoprazole.

Both antibiotics in the group, cephalexin 500 mg capsules and amoxicillin 500 mg capsules, peaked recently. Cephalexin reached 14.8 cents in December 2023 and amoxicillin 10.6 cents in March 2024. Both have eased since, though amoxicillin is still 16 percent above October 2021. GxRadar's account of the amoxicillin shortage of 2022 and 2023 covers the period just before those peaks.

Apart from the furosemide and allopurinol entries above, none of the drugs in the table appeared in the openFDA shortage data as of Oct. 30, 2026. That feed mirrors FDA's drug shortage database⁸ as it stands now, with few resolved entries, so an empty search today does not rule out an earlier shortage. Our shortage tracker uses the same openFDA feed.

Digoxin, a spike that mostly unwound

Digoxin shows why the starting point matters. In the first weekly files in November 2013, the 125 mcg tablet cost pharmacies 10.6 cents. In December 2013 it cost 91.2 cents, more than eight times as much, according to the 2013 NADAC data¹. It peaked at $1.09 in March 2014.

Digoxin was among 10 older generics that a written statement at a November 2014 Senate subcommittee hearing¹⁰ said lawmakers had cited as examples of steep increases. The price then fell for most of a decade. In October 2026 digoxin cost 86 percent less than in January 2014, and 20 percent more than in November 2013. Our doxycycline analysis follows a similar spike and its slow decline, and our history of the generic price spikes of 2013 to 2015 puts both in context.

What shortage research can and cannot explain

Federal researchers have described the economic pressure on old generics without tying it to individual price moves. FDA's drug shortages task force wrote in its 2019 report on root causes⁹ that manufacturers of older generic drugs "face intense price competition, uncertain revenue streams, and high investment requirements," and that contracting practices contribute to a "race to the bottom" in pricing. It also found that only 18 percent of drugs that went into shortage from 2013 to 2017 had a sustained price increase.

Any of those pressures could apply to a given drug, or none. NADAC records what pharmacies paid on their invoices, excluding off-invoice discounts, according to the CMS methodology⁶. It does not record why. For the broader downward trend, see the long deflation of generic prices, and for how the survey works, how NADAC is calculated.

The full basket, with monthly series for all 47 drugs, is on our prices page. CMS updates NADAC weekly, and the furosemide oral solution entry on FDA's shortage list was last updated on Oct. 27, 2026.