Ready to pay more? Study names Lexington most expensive US city for cash prescriptions
Lexington is the most expensive city in the U.S. to purchase prescription medications at cash prices, without insurance, according to a recent study from GoodRx Health.
GoodRx’s business model involves people purchasing prescriptions through the company instead of using insurance, so the study reflects cash pricing. The majority of adults in the U.S. have some level of prescription coverage.
The study compared pricing for the 500 most commonly prescribed medications across 30 U.S. cities. It included prices from 60,000 pharmacies nationwide, but it was unclear whether an equal number were analyzed in each city and specific pharmacies for each location were not provided.
“Prices for prescription drugs in Lexington are 15.88% above the national average, making it the most expensive city for prescription drugs,” Tori Marsh, director of research at GoodRx wrote in an email to the Herald-Leader. “Large coastal cities that have high cost of living, like Los Angeles and New York, tend to have the highest prices, so seeing a smaller city like Lexington at the top of the list was surprising.”
Here are the five most and least expensive cities in the U.S. for prescription drug cash pricing, from GoodRx:
Most expensive:
- Lexington, 15.88% above national average
- Little Rock-Pine Bluff, Ark., 12.86%
- Los Angeles, 12.48%
- New Orleans, 11.2%
- New York, 10.46%
Least expensive:
- Denver, Colo., 39.35% below national average
- Atlanta, 18.51%
- Houston, 17.01%
- Detroit, 16.89%
- Tampa-St. Pete (Sarasota), Fla., 15.9%
Medication pricing can vary based on a variety of factors, including whether you purchase generic or brand-name drugs and whether you buy from a small pharmacy versus a big box store, according to Dr. Joey Mattingly, an associate professor of Pharmaceutical Health Services Research at the University of Maryland’s School of Pharmacy.
“If medications are treated like retail products, the same as candy bars and sodas, if you go to 100 different gas stations you’re going to find 100 different prices, potentially, for sodas and candy and whatnot,” Mattingly told the Herald-Leader.
The GoodRx study used the following methodology, according to the company’s website:
“To determine the most and least expensive cities for prescription drugs, we observed the cash prices of the 500 most commonly prescribed medications in 30 U.S. cities from July 1, 2021 to July 1, 2022. These numbers are based on a representative sample of U.S. prescription fills (not fills using GoodRx) and come from several sources, including pharmacies and insurers.”
While there aren’t all-encompassing rules that govern free market drug pricing in the U.S., smaller pharmacies could tend to charge more for prescriptions if they don’t make the majority of their revenue from other products.
One possible factor in cities’ rankings in the GoodRx study could be whether large, expensive chains are more prevalent in a particular area, Mattingly said. Additionally, depending on how frequently the 500 drugs are prescribed, there could be relatively rare drugs at the end of the list pushing average prices up.
“Drug pricing is complex, so there could be a number of factors influencing Lexington’s drug prices. Record-high inflation has driven up energy costs across the country, which impacts the entire prescription drug supply chain,” Marsh, with GoodRX, said. “Also, some states have fewer big-box stores that offer generic and brand-name drugs at lower prices. With fewer pharmacy options, residents are less able to shop around for lower prices.”
“That said, it is hard to know exactly what is playing into the higher prices in Lexington, as there are many variables at play,” Marsh added.
Lexington hasn’t recently made the top of GoodRx’s list of the most expensive cities for prescription drugs at cash prices.
“In recent years, Lexington’s prices have been generally low / fallen in the middle of our list. It’s only in the last year that we’ve seen a dramatic price increase,” Marsh told the Herald-Leader.
The good news is if you use prescription insurance, you likely won’t see as much variation in pricing as long as each pharmacy you consider accepts your insurance.
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