Examples of the Relative Costs of Prescription Drugs

The following information will help you understand the costs associated with your prescription drug benefits. Please use this information to make better decisions.

The information is organized by categories based on medical need and is for the dosage most used by the members of Deseret Mutual's medical plans.

Pricing is current as of: May 17, 2004.

Central Nervous System (depression, anxiety, etc.)
Drug Name
Retail Pharmacy*
(90 Day Supply )
Home Delivery Pharmacy
(90 Day Supply)
Member's Annual Coinsurance
Member's Cost
Plan's Cost
Member's Cost
Plan's Cost
Retail Pharmacy
Home Delivery Pharmacy
Fluoxetine (20mg)
(Generic for Prozac)
$16.20
$37.80
$10.41
$31.23
$64.80
$41.64
Prozac (20mg)
$154.92
$154.92
$141.22
$141.22
$619.80
$564.88
Zoloft (100mg)
(Generic available in 2005)
$62.10
$207.00
$47.05
$188.20
$248.40
$188.20
Paroxetine (20 mg)
(Generic for Paxil)
$60.30
$140.73
$46.98
$140.94
$241.20
$187.92
Paxil (20mg)
(Generic available in 2006)
$119.28
$119.28
$108.07
$108.07
$477.12
$432.33
Bupropion Hci Sr Tabs
(Generic for Welbutrin Sr - Preauthorization required through Medco Health)
$42.87
$99.99
$34.22
$102.64
$171.48
$136.88
Welbutrin SR (150mg)
(Preauthorization required through Medco Health)
$85.32
$85.32
$76.51
$76.51
$341.28
$306.04
Effexor XR (150mg)
$75.78
$252.60
$57.64
$230.56
$303.12
$230.56

 

Cardiovascular (cholesterol, high blood pressure)
Drug Name
Retail Pharmacy*
(90 Day Supply )
Home Delivery Pharmacy
(90 Day Supply)
Member's Annual Coinsurance
Member's Cost
Plan's Cost
Member's Cost
Plan's Cost
Retail Pharmacy
Home Delivery Pharmacy
Zocor (20mg) 
$113.01
$263.70
$70.00
$270.36
$452.04
$280.00
Lipitor (40mg) 
$89.18
$208.14
$66.65
$199.93
$356.76
$266.70
Norvasc (10mg) 
$51.17
$128.73
$40.29
$120.87
$220.68
$161.16
Lisinopril (20mg)
$17.37
$54.00
$11.84
$35.53
$69.48
$47.36
Lovastatin (20mg)
 (Generic for Mevacor)
$28.05
$65.40
$20.74
$62.20
$112.20
$82.96

 

Gastroenterology (heartburn, ulcers, etc.)
Drug Name
Retail Pharmacy*
(90 Day Supply )
Home Delivery Pharmacy
(90 Day Supply)
Member's Annual Coinsurance
Member's Cost
Plan's Cost
Member's Cost
Plan's Cost
Retail Pharmacy
Home Delivery Pharmacy
Nexium (40mg) 
$114.87
$268.05
$70.00
$276.13
$459.48
$280.00
Omeprozole (20mg)
(Generic for Prilosec 20 mg strength only)
$80.88
$188.70
$64.77
$194.30
$323.52
$259.08
Prilosec (20mg) 
$181.74
$181.74
$164.05
$164.05
$727.08
$656.20
Protonix (20mg)
$90.93
$212.19
$67.99
$203.97
$363.72
$271.96

Famotidine
(Generic for Pepcid)

$15.27
$35.67
$10.11
$30.34
$61.08
$40.44

 

Endocrine and Diabetes
Drug Name
Retail Pharmacy*
(90 Day Supply )
Home Delivery Pharmacy
(90 Day Supply)
Member's Annual Coinsurance
Member's Cost
Plan's Cost
Member's Cost
Plan's Cost
Retail Pharmacy
Home Delivery Pharmacy
Actos (30mg) 
$136.38
$318.24
$70.00
$342.76
$545.52
$280.00
Avandia (4mg) 
$72.54
$169.29
$53.57
$161.25
$290.16
$215.00
Metformin HCL (1000mg) 
(Generic for Glucophage)
$15.00
$29.82
$10.00
$24.33
$60.00
$40.00
Synthroid (0.125mg)
$17.34
$40.44
$10.99
$32.95
$69.36
$43.96

 

Arthritis (Cox 2)
Drug Name
Retail Pharmacy*
(90 Day Supply )
Home Delivery Pharmacy
(90 Day Supply)
Member's Annual Coinsurance
Member's Cost
Plan's Cost
Member's Cost
Plan's Cost
Retail Pharmacy
Home Delivery Pharmacy
Vioxx (25mg) 
$75.63
$176.49
$56.14
$168.42
$302.52
$244.56
Celebrex (200mg) 
$74.61
$174.12
$55.35
$166.05
$298.44
$221.40
Relafen (500mg)
$72.93
$72.93
$62.91
$62.91
$291.84
$251.68
Nabumetone (500 mg)
$27.45
$64.08
$20.26
$60.76
$109.80
$81.04

 

Respiratory (allergies, asthma)
Drug Name
Retail Pharmacy*
(90 Day Supply )
Home Delivery Pharmacy
(90 Day Supply)
Member's Annual Coinsurance
Member's Cost
Plan's Cost
Member's Cost
Plan's Cost
Retail Pharmacy
Home Delivery Pharmacy
Clarinex (5mg)
(Preauthorization required through Medco Health)
$62.07
$144.84
$45.65
$136.90
$248.28
$182.56
Claritan
(Available Over the Counter at Retail Pharmacies)
$43.20
Not Available
$172.80
N/A
Allegra (180mg) 
(Preauthorization required through Medco Health)
$61.53
$143.55
$45.21
$135.63
$246.12
$180.84
Singulair (10mg)
(Preauthorization required through Medco Health)
$75.00
$174.96
$55.64
$166.90
$300.00
$222.56
Advair Diskus (250-50M)
(Preauthorization required through Medco Health)
$128.16
$299.04
$70.00
$317.28
$512.64
$280.00

*Retail pharmacies will only dispense a 30 day or 90 dose (whichever is greater) script. These costs were determined by taking the cost for a normal retail Pharmacy supply and multiplying by three to get a cost equivalent to the home Pharmacy's standard 90 day supply.


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