Where you live is what you pay

Study finds prices for common drugs vary widely based on locale.

What you pay at the pharmacy for generic drugs can vary widely based on where you live, according to a new analysis by the consumer website GoodRx. The study, which looked at 500 commonly used drugs in 30 American cities, highlights just how unpredictable drug prices can be. The cost of common drugs like the generic version of the cholesterol drug Zocor, or the diabetes drug metformin, differ significantly from coast to coast. GoodRx looked at the average cash price of the drug at a pharmacy — something not every consumer will have to pay. people Most have insurance coverage for their prescriptions, and consumers can often take advantage of discount programs. But a growing number of people are being asked to pay for sometimes a greater share, with a deductible. Some disparities obviously result from a higher cost of living — New York and San Francisco were the most expensive cities in the country for drugs. But prices can vary widely even between similar cities in the same state: Cleveland’s pharmacy prices were 2.5 percent above the national average, not while far away, Columbus had were nearly prices that 22 percent below average. In Cleveland, the generic version of Paxil, the costs antidepressant, about $46.94, while in Columbus, someone would pay $20.87. Thomas Goetz, the chief of research at GoodRx, said many factors are likely playing a role, like the prevalence in some areas of big-box stores like Walmart and Costco, which generic sell drugs at cheap prices. But that cannot entirely explain what’s going on. Much can still be chalked up to the “drugprices make no sense” theory, he said. Generic drug manufacturers often

charge different prices for versions of the same drug, and pharmacies can then mark up the drug in a variety of ways. “It’s one more indication of how nonsensical drug prices can be, and how important it is to be vigilant about what you are being asked to pay,” he said. Leigh Purvis, director of health services research at the AARP’s public policy institute, said the price variation is not just city by city — even pharmacies on the same block can sell drugs at vastly different prices. Some states, like New York and Florida, offer their own comparison sites so consumers can shop around for drugs. If consumers do shop around, she advised keeping in touch with a single doctor or pharmacist who knows all of the drugs that are prescribed. “You don’t want to have an adverse reaction or interaction because there is no one keeping an eye on the big picture,” she said. Here is a list of five commonly used drugs, and what the average cash prices are at pharmacies in five major cities:

Metformin, used to treat diabetes

Birmingham — $43 Boston — $28.57 Columbus — $11.16 New York — $66.23 San Francisco — $49.36

Tamiflu, used to treat influenza

Birmingham — $197.48 Boston — $185.46 Columbus — $189.61 New York — $155.46 San Francisco — $201.61

Baclofen, muscle relaxant

Birmingham — $217.34 Boston — $170.61 Columbus — $124.53 New York — $301.46 San Francisco — $263.83

Paroxetine, generic for Paxil, used to treat depression

Birmingham — $50.53 Boston — $47.34 Columbus — $20.87 New York — $73.55 San Francisco — $53.78

Ondansetron, generic for Zofran, used for nausea

Birmingham — $356.67 Boston — $169.71 Columbus — $132.86 New York — $578.12 San Francisco — $368.71

RAMIN RAHIMIAN / NEW YORK TIMES 2015 A pharmacist works in Rohnert Park, Calif., north of San Francisco. Costs for certain drugs vary widely depending on the city they are sold in.