What pharmacies paid for montelukast, 2013 to 2026

In November 2013, the first month of the federal government's weekly drug cost survey, retail pharmacies paid an average of 26.7 cents for a generic 10 mg montelukast tablet, according to the 2013 NADAC files¹ that the Centers for Medicare & Medicaid Services publishes for Medicaid. In October 2026 they paid 4.3 cents, according to the 2026 files⁵.

That is a fall of 84 percent. Thirty tablets went from $8.01 in ingredient cost to $1.28.

Montelukast, a tablet used for asthma and allergies, had been generic for barely 15 months when the series began, which makes its record a clean look at how a drug's price settles after a big generic launch. GxRadar analyzed CMS NADAC files from November 2013 through October 2026 and set them against FDA approval records and the agency's 2020 safety action on the drug. The price fell steadily for six years, rose for about two, and has fallen again since.

Thirteen years of one tablet's cost

Each figure is GxRadar's monthly median of the weekly NADAC per-tablet rate for generic-classified 10 mg montelukast tablets. The table uses October of each year plus the first month of the series. The full monthly series is on our montelukast page.

Source: GxRadar analysis of CMS NADAC weekly files, November 2013 to October 2026. Generic-classified rows only. Ingredient cost only, not adjusted for inflation.

November 2013 is the highest month in the whole series. From there the figure fell almost every year until 2019. The steepest annual drop was between October 2016 and October 2017, when it lost 31 percent, according to the 2017 NADAC files².

The August 2012 launch

Generic montelukast arrived all at once. On Aug. 3, 2012, FDA approved 10 abbreviated new drug applications (ANDAs) for the 10 mg tablet, according to GxRadar's count of FDA's Drugs@FDA data, queried through openFDA⁷. The brand tablet had been approved in February 1998 and is still listed as marketed under its own application.

Source: GxRadar count from the openFDA record for montelukast sodium⁷, downloaded November 2026. Tentative approvals excluded.

A launch with that many competitors on day one usually drives the price down fast, a pattern GxRadar traces in why generic prices fall as competitors enter. FDA economists found in a 2019 analysis¹¹ that once six or more generic makers were selling a drug, prices ran more than 95 percent below the brand price before generic entry. The federal series starts too late to show the first months after August 2012, but by November 2013 montelukast was already well into its slide, and it kept falling for six more years as additional approvals came through.

The 2020 boxed warning

On March 4, 2020, FDA announced that it was requiring a boxed warning, which it called "our most prominent warning," on montelukast's prescribing information to describe serious mental health side effects, according to the agency's drug safety communication⁸. FDA also said it was requiring a new patient Medication Guide, and that for allergic rhinitis the drug should be reserved for people who are not treated effectively with, or cannot tolerate, other allergy medicines. Our explainer on Medication Guides describes what those documents contain. Questions about the warning are for a prescriber or pharmacist.

The NADAC record shows no sharp move around the announcement. The monthly figure was 6.4 cents in February 2020, 6.3 cents in March and 6.2 cents in April.

The rise came later. The figure climbed through the rest of 2020 and jumped 22 percent in January 2021, to 8.9 cents, according to the 2021 NADAC files³. It touched 8.6 cents again in July 2021, then eased back to about 6 cents by February 2022. NADAC captures invoice prices and nothing about why they changed, so the data cannot say whether the warning, demand, supply or something else drove that bump.

Quality records and supply

FDA's drug enforcement database¹⁰ holds 14 recall records since 2013 whose product descriptions mention montelukast, across tablets, chewable tablets, oral granules and the active ingredient. One was Class I, a 2018 label mix-up involving a bottle of 10 mg tablets. Six were dated in 2023. The GxRadar recall tracker lists recall records by year and class.

Montelukast 10 mg tablets were not on FDA's shortage list as of Oct. 30, 2026. The list did carry a discontinuation notice for one montelukast chewable tablet presentation, posted Nov. 17, 2025, according to FDA shortage data from openFDA⁹. The GxRadar shortage tracker shows the full list.

The 2024 swings and what came after

Like nearly every generic in the federal data, montelukast lurched in 2024. The monthly figure fell 17 percent in July 2024 to 4.6 cents, recovered to 5.8 cents by October, and was back at 4.6 cents in December, according to the 2024 NADAC files⁴. CMS attributed that kind of volatility to fluctuations in pharmacy participation in its monthly survey and began calculating generic rates as a three-month moving average with the December 2024 updates, according to its December 2024 methodology⁶. Our explainer on how NADAC is calculated covers the survey behind the rates.

Since then the line has been smoother and mostly downhill. The figure reached a series low of 4.1 cents in August 2026 and stood at 4.3 cents in October. Those are ingredient costs only, before dispensing fees and markups. Our explainer on what NADAC measures covers what the benchmark leaves out, and the GxRadar price pages carry the monthly series for montelukast and 46 other generics.