The Self-Pay Patient takes his own medicine – adventures in pharmacy prices

So I’m having surgery tomorrow. Nothing terribly serious, just several outpatient procedures on the throat and nose area to deal with sleep apnea, snoring, and related issues. At the pre-op interview at my surgeon’s office, they gave me several prescriptions to fill in advance, so the medicines will be already at home when I return tomorrow afternoon.

I’ve mentioned previously here at The Self-Pay Patient,  there are lots of ways to save on prescription medications. Because I need to get the medications today, a mail-order service really isn’t an option for me. So I turned to and after getting prices from several local pharmacies I called my local Costco pharmacy to see if they could beat the price (Costco apparently only lists drug prices for their mail-order operation, you have to call to get local prices. More on that in a second).

The results were interesting. Of the three medications I need (Lortab, Promethazine, and Amoxicillin), Walmart was easily the least expensive I found at  All the prices are for generics. 

Amoxicillin is one of Walmart’s $4 generics, meaning up to a 30-day supply for only $4 ($10 for a 90-day supply). The nearest competitors were charging in the $8 to $11 range.

The Promethazine was also less expensive at Walmart, although here the price differences were narrower – $7.61 for 30 tablets, compared to $10 to $12 from other nearby pharmacies. That price is with a coupon that appears to come from a partnership between and a pharmacy benefits manager.

Finally, the Lortab costs $15.44 for 180 tablets at Walmart, compared to $17 – $25 from other local pharmacies. That also comes with a coupon from

After getting these prices online, I called up my local Costco pharmacy. They wouldn’t give a price for Lortab over the phone because their policy is not to give prices for controlled substances (Lortab is an opiate). I did get the pharmacist to tell me that their price was a little bit more to Walmart’s after I told her the price I’d found online.

Then I realized that I’d been looking at prices for tablets online, whereas two of the three medications I’d been given prescriptions for called for solutions or suspensions! The Walmart price for Lortab I’d found online was for tablets, not suspension, while Costco was giving me the solution price.

I got the remaining prices from Costco – $6.40 for the Promethazine (in tablet form), and $20.03 for the Amoxicillin in suspension. Then I called the local Walmart to see what their prices were for the solution and suspension forms. Their price for Amoxicillin was lower, only $8 for the suspension form. But the Lortab price they quoted me was much higher – $173.84! The Walmart pharmacy also told me they were out of stock on the suspensions and solutions.

So, decision made – Costco it is!

The lessons for self-pay patients aren’t just to shop around and compare prices in order to get the best deal and to get generics whenever you can. It’s also to pay close attention to the details of dosage, quantity, and the form the drugs come in, or else you won’t be getting good comparison information.

I should mention that my insurance does cover prescription drugs, but my deductible hasn’t been met yet and even if it had, co-pays for one of the 3 drugs are more than the cash price. So even with insurance, I am a self-pay patient for these medications.

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