What pharmacies paid for sertraline and escitalopram, 2013 to 2026

In January 2014, retail pharmacies paid an average of $4.28 for 30 generic escitalopram 10 mg tablets (14.27 cents a tablet), according to the federal government's NADAC survey files¹. By October 2026 the same 30 tablets cost $1.18 (3.93 cents a tablet), a drop of 72 percent, according to the 2026 files². Over the same years, 30 generic sertraline 50 mg tablets went from $1.58 to $1.04.

A third drug in the same class went the other way over the last five years. Thirty citalopram 20 mg tablets cost pharmacies 89 cents in October 2021 and 90 cents in October 2026. Citalopram is one of only three drugs in GxRadar's 47-drug price basket whose NADAC rate is higher now than five years ago.

All three are selective serotonin reuptake inhibitors, according to the National Library of Medicine's MedlinePlus entries for sertraline³, escitalopram⁴ and citalopram⁵. This piece is about acquisition prices only, what pharmacies pay to buy the tablets, and not what anyone pays at the counter. Questions about any medicine belong with a prescriber or pharmacist. GxRadar analyzed CMS NADAC files from November 2013 through October 2026, FDA approval records and Medicare and Medicaid prescription data to show how the three price records differ and what sits behind each.

Three price records, side by side

Each figure is GxRadar's monthly median of the weekly NADAC per-tablet rate for generic-classified rows of one strength, drawn from the yearly files on data.medicaid.gov starting with the 2013 file⁶. The cost shown is for 30 tablets, the typical fill for each of the three in Medicaid's 2025 State Drug Utilization Data⁷. Fill sizes describe how prescriptions are commonly dispensed and say nothing about dosing. The per-tablet rate follows in parentheses.

For comparison, the GxRadar generic price index stood at 47.4 in October 2026, about 53 percent below January 2014. Escitalopram fell further than the basket. Sertraline and citalopram, both cheap in 2014, fell less. Full monthly series are on the sertraline, escitalopram and citalopram pages.

Why escitalopram fell furthest

Timing explains most of it. FDA approved the original escitalopram tablets on Aug. 14, 2002, sertraline's on Dec. 30, 1991, and citalopram's on July 17, 1998, according to Drugs@FDA records⁸. Generic approvals followed in that order, too. GxRadar counted the single-ingredient ANDAs for each drug in FDA's data.

Citalopram's first ANDAs date from Oct. 28, 2004. For sertraline, the first 50 mg tablet ANDA dates from June 30, 2006, and 16 more were approved on a single day, Feb. 6, 2007. Escitalopram's first 10 mg tablet ANDA dates from March 14, 2012, and nine were approved on Sept. 11, 2012. When the NADAC series began in late 2013, escitalopram was barely a year past its main generic wave, and its price still had a long way to fall. FDA economists found in a December 2019 analysis⁹ that prices fall further as generic makers multiply, by "more than 95%" against the brand once six or more compete. Our explainer on why generic prices fall as competitors enter covers the pattern.

Escitalopram's fall was not smooth. The rate rose to 15.96 cents in October 2014, the series high, and sat near 15 cents as late as July 2015. It dropped to 9.88 cents by that October, according to the 2015 NADAC files¹⁰, bounced back to 13.34 cents in April 2016 and then resumed its slide. Thirty tablets reached $1.13 (3.76 cents a tablet) in December 2024, the series low.

Sertraline's two-month spike and the 2024 swings

Sertraline has the steadiest record of the three, with one exception. In August and September 2020 its rate jumped to 6.82 and 6.73 cents, putting 30 tablets at $2.05, the highest in the series, before dropping to 4.60 cents in October, according to the 2020 NADAC files¹¹. The files show the spike but not its cause.

All three drugs swung through 2024 and bottomed in December of that year, according to the 2024 files¹². Sertraline fell to 3.15 cents, escitalopram to 3.76 cents and citalopram to 2.58 cents. Our account of the 2024 NADAC swings describes how thin survey participation moved many generic rates that year. CMS's December 2024 methodology¹³ answered with "a temporary, short-term measure to address rate volatility occurring as a result of fluctuations in survey participation," a three-month moving average for generic rates. Citalopram rose back to 3.20 cents by April 2025, according to the 2025 files¹⁴, and has stayed between 2.8 and 3.2 cents since, about where it sat in 2021. Sertraline and escitalopram kept falling.

How much of each gets filled

Medicare and Medicaid data show sertraline and escitalopram growing and citalopram shrinking. CMS's Part D Spending by Drug data¹⁵ show claims for generic sertraline up from 14.1 million in 2020 to 16.1 million in 2024 and generic escitalopram up from 9.9 million to 12.7 million. Generic citalopram fell from 7.9 million to 6.7 million.

Part D figures cover all strengths and forms, and CMS's methodology¹⁶ defines spending as gross drug cost, including dispensing fees and before rebates. The Medicaid column counts prescriptions for the NADAC product described in this piece, from the 2025 State Drug Utilization Data⁷.

Supply has been quiet. FDA's shortage list as of Nov. 3, 2026 had no entry for any of the three, according to the openFDA shortage data¹⁷ behind our shortage tracker. The openFDA enforcement records¹⁸ hold seven recall records naming sertraline, two naming escitalopram and eight naming citalopram since 2012. None was Class I. Our recall tracker uses the same data.

What the price leaves out

At $1.04 to $1.18 for 30 tablets, the ingredient is a small share of what a prescription costs to fill. New Jersey Medicaid pays a $10.92 professional dispensing fee and New York pays $10.18, according to CMS's state reimbursement table for the quarter ending September 2026¹⁹. Our earlier look at six generic antidepressants adds fluoxetine, trazodone and duloxetine to the comparison, and our explainer on what NADAC measures covers what the survey leaves out. CMS says on its NADAC page²⁰ that the moving average "will continue until further notice." Citalopram's rate rose in each of the last two months of the series, from 2.87 cents in August 2026 to 2.99 cents in October.