Here are the Most, and Least, Expensive Cities for Prescription Medications

The data looked at cash prices of the 500 most commonly prescribed medications in 30 of the most populated cities in the US over the last 12 months (ending April 2018). These numbers are based on a representative sample of US prescription fills (not fills using GoodRx) and comes from several sources including pharmacies and insurers.



This data highlights the nonsensical and variable nature of drug pricing. Take Cleveland and Columbus for instance. These two cities in Ohio are a mere 150 miles apart, but their prices for prescription drugs differ significantly. In Cleveland, drug prices as a whole are 2.50% higher than the national average, while in Columbus, they are 21.70% lower than the national average. How is it that cities in the same state could have such wildly different pricing for prescription drugs?

Differences in cost of living might account for some of the large price variations. Cities with a higher cost of living, like SF and NY, have higher costs for prescription drugs. But this doesn’t explain the full story.

For instance, prices for drugs in Washington DC — where the cost of living is relatively high — are 9.60% lower than the national average. Alternatively, Raleigh, which has a lower cost of living, has higher prescription drug costs, around 4.30% higher than the national average.

Another factor that could be at play here is a phenomenon that we refer to as the “big box effect”.  Many larger big box stores offer popular brand and generic drugs for cheap, often $4 for a 30-day supply and $9 for a 90-day supply. Some states have more of these big box stores, giving residents more opportunities to save on medications.

There is also the matter of the retail markup that a pharmacy puts on a prescription. Some pharmacies will claim a higher margin to support their business, and those pharmacies may be distributed unevenly across states.

These probably aren’t the only factors at play, but one thing is for sure: drug pricing is complex.

So, how can I save?

If your city is on the most expensive list, don’t panic. There are other ways to save.

  • Shop around. Prescription drug prices can vary from one pharmacy to the next, so it pays to shop around before you buy.
  • Use a GoodRx coupon. On average, GoodRx users can save an average of 59% off the retail price of your drug. In some cases, GoodRx can even beat insurance co-pays.
  • Look for a pharmacy discount program in your area. These programs, also called prescription savings clubs, offer patients discounts on generic medications, pet medications and other select medical supplies and devices. Pharmacies like Sam’s Club, Walgreens, and Walmart offers these programs. Read more about these programs here.
  • Fill a 90-day supply. If you’re taking a medication for a chronic condition, filling a 90-day supply instead of a 30-day supply at one time can help keep your costs down, whether you’re filling at a retail pharmacy or through your insurance mail order service.
  • Start a conversation with your doctor or pharmacist. If you’re having trouble affording your prescription, let your healthcare provider know. They can help you work through insurance coverage issues and/or find affordable alternative medications for you.

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