Prices & costs
What pharmacies pay, how prices are set and why they move. 35 articles: 21 data story, 13 explainers, 1 history.
Price histories
How the price of generic sildenafil 20 mg fell 92 percent
Federal NADAC data show a generic 20 mg sildenafil tablet fell from 65.9 cents in 2013 to 5.2 cents in 2026, mostly after 2016. FDA approval records for both sets of strengths, and a tadalafil comparison.
The cheapest pills in GxRadar's 47-drug price basket
Seven of the 47 generics we track cost pharmacies under 2 cents a unit in October 2026, led by amlodipine at 1.02 cents. Which drugs sit at the floor, how long they have been there, and what the ranking does not show.
What pharmacies paid for gabapentin, 2013 to 2026
The pharmacy cost of a generic 300 mg gabapentin capsule fell from 5.6 cents in 2013 to a series low of 3.0 cents in September 2026, with a sharp rise in between. The NADAC record and the FDA approvals behind it.
What pharmacies paid for metformin, 2013 to 2026
A generic 500 mg metformin tablet has cost pharmacies about a cent and a half for 13 years. The NADAC record, what 730 tablets cost at that rate, and why the price has stayed so low.
What pharmacies paid for montelukast, 2013 to 2026
Federal NADAC data show the pharmacy cost of a generic 10 mg montelukast tablet fell 84 percent from 2013 to 2026. The year-by-year record, the 2012 generic launch and the 2020 boxed warning.
What pharmacies paid for omeprazole, pantoprazole and famotidine
Pharmacy costs for generic omeprazole and pantoprazole fell by more than half from 2013 to 2026. Prescription famotidine jumped 68 percent after the 2020 ranitidine withdrawal, then fell back below its 2013 level.
What pharmacies paid for simvastatin, 2013 to 2026
Federal survey data put a generic 20 mg simvastatin tablet at 2.7 cents in November 2013 and 3.2 cents in October 2026. The year-by-year record, the 2023 jump and the approvals behind the market.
What pharmacies paid for six generic antidepressants, 2013 to 2026
Federal NADAC data for sertraline, escitalopram, citalopram, fluoxetine, trazodone and duloxetine show three very different price paths since 2013, and FDA approval records help explain them.
What pharmacies paid for warfarin and clopidogrel, 2013 to 2026
Federal NADAC data show generic warfarin jumped in 2014 and never returned to its 2013 price, while clopidogrel, generic since 2012, lost more than half its price in two bursts.
What pharmacies pay for seven blood pressure generics, 2014 and 2026
At federal survey rates, 365 tablets each of seven common blood pressure generics cost pharmacies about $95 in October 2026, down from $1,403 in October 2014. One drug explains most of the drop.
Doxycycline's 2013 price spike and the decade-long fall that followed
In late 2013 pharmacies paid $3.36 for one generic doxycycline capsule. By October 2026 they paid 11 cents. What federal records say about the spike, and how slowly the price came back down.
How fast generic prices fell for rosuvastatin, duloxetine and tadalafil
Federal cost data show three widely used generics each fell more than 90 percent within 24 months of entry. One did it in five weeks. Month-by-month figures, lined up against FDA approval dates.
Levothyroxine and the price of a daily pill
Pharmacies paid 38.4 cents for a generic 50 mcg levothyroxine tablet in early 2015 and 4.0 cents in October 2026. The year-supply arithmetic, the FDA history behind the drug, and why NADAC is not what patients pay.
Nitrofurantoin and the antibiotic price story
Pharmacies paid $1.77 for a nitrofurantoin capsule in January 2014 and 28 cents in October 2026. How six oral antibiotics' prices diverged, why competition explains much of it, and where shortages fit.
The generics that cost pharmacies more than they did in 2014
Most generics in GxRadar's 47-drug basket got cheaper. Seven cost pharmacies more than in January 2014, led by furosemide at 2.8 times its 2014 price. What federal cost and shortage data show, drug by drug.
The GxRadar generic price index
We priced a fixed basket of 43 common generics every month since January 2014. By October 2026 the index stood at 47.4, down about 53 percent. How it works, and where it can mislead.
What pharmacies paid for atorvastatin, 2013 to 2026
Federal survey data show the pharmacy cost of a generic 20 mg atorvastatin tablet fell from 18.3 cents in November 2013 to 2.8 cents in October 2026. The year-by-year record, and the FDA approvals behind it.
What pharmacies pay for a month of common generics
Thirty tablets of each of the 10 most-used generics we track cost pharmacies $35.70 in January 2014 and $8.80 in October 2026. That is acquisition cost, and the rest of the price sits on top of it.
Benchmarks & how prices are set
Average manufacturer price, the confidential number behind Medicaid drug rebates
AMP is the price drugmakers report to Medicaid each month. It sets rebates, triggers inflation penalties and anchors federal payment caps, yet no single company's figure can be made public.
How pharmacy dispensing fees work
Medicaid pays pharmacies a per-prescription fee built from state cost surveys, mostly $10 to $11 in 2026. Medicare drug plans negotiate their own, which federal advisers describe as typically a fixed amount such as $1.
How the NADAC survey picks its pharmacies, and who answers
The monthly CMS survey behind NADAC: who is sampled, what invoices pharmacies send, why voluntary response made rates jumpy, how the 2024 moving average changed that, and how rate reviews work.
The 2024 NADAC swings, and the three-month average that followed
In 2024 the federal benchmark for generic drug costs lurched up and down across nearly every drug at once. Our basket index shows the swings month by month, and what changed when CMS switched to a moving average.
The federal upper limit, Medicaid's ceiling on generic drug payments
The FUL caps Medicaid spending on generics at 175 percent of average manufacturer prices, or at pharmacy cost when that is higher. In October 2026 the pharmacy-cost floor set it for 59 percent of drug groups.
How NADAC is calculated
The CMS method behind NADAC, step by step: the monthly invoice survey, cleaning rules, simple averaging, weekly updates and explanation codes, plus what the comparison file shows about when rates move.
How pharmacies get paid for a prescription
Ingredient cost plus a dispensing fee is the starting formula. MAC lists, Part D price concessions and spread pricing shape what a pharmacy keeps, as federal rules and government reports document.
The brand-generic gap in NADAC
In CMS's Oct. 28, 2026 cost file, brand tablets and capsules cost pharmacies a median 21 times the matching generic. For amlodipine the multiple was 857. Where the gap is widest, and where it nearly closes.
WAC, AWP, NADAC, MAC, FUL and ASP compared
Six price benchmarks run through US drug payment, and none is what a patient pays. Who sets each one, what goes into it, where it is used, and how far apart they can sit for the same pill.
What NADAC measures, and what it leaves out
NADAC is the federal estimate of what retail pharmacies pay for a drug. Who publishes it, how the invoice survey works, how Medicaid uses it, and why it is not the price a patient pays.
Why the same generic costs different amounts at different pharmacies
Cash quotes for the same three heart-failure generics ranged from $12 to almost $398 across 175 pharmacies in one 2016 study. Federal cost data show how little of that price is the drug itself.
Market economics
What happens to Medicaid spending when the first generic arrives
Federal research on prices after generic entry, and four worked examples from NADAC and Medicaid claims data: duloxetine, valsartan, rosuvastatin and tadalafil.
Why drug prices change in January
Most drug list-price changes take effect Jan. 1, the day plan deductibles reset. Inflation rebates now push back on increases, and pharmacy cost data show no January jump for common generics.
The economics of making a generic
What it costs to bring a generic to market and make it, how competition drives the price down, and why federal analyses find many launches unprofitable years later, using ASPE, FDA and NADAC data.
The generic price spikes of 2013 to 2015
Generic prices fell overall in the early 2010s, yet 315 established generics at least doubled in price. What GAO and HHS investigators found, what CMS price data show, and what Congress changed.
The long deflation of generic prices
Of 43 common generics in GxRadar's NADAC series, 35 cost pharmacies less in October 2026 than in January 2014. Federal data show how competition drives that decline, and the rarer spikes.
Why generic prices fall as competitors enter
One generic maker cuts the brand price by about 39 percent; six or more cut it by over 95 percent. FDA's 2019 study, GAO data and GxRadar's NADAC files show how steep the curve is and why.