October 26, 2018 by Dr. Kyle Varner in Prescriptions without Insurance

If the cost of your prescription drugs has you pulling out your hair, you’ve come to the right place.

Over the last few weeks, I’ve written about a number of strategies you can take to try to cut down your prescription drug costs—from switching from brand name to generic alternatives or getting discounts online.

Another key strategy to reduce your monthly prescription bill starts by looking at the ingredients in the medications you are taking.

In my last post, I wrote about some of the insane tricks that pharmaceutical companies are engaging to dramatically raise the prices of prescription drugs. Some have even gone so far as to patent fish oil, slap a brand name on it, and then charge 30x more for the same thing. It’s crazy.

But that’s not the only way that pharmaceutical companies play with ingredients to sneak more money out of your pockets. Another tactic they use through what are called combination drugs.

Here, pharmaceutical companies take two or more drugs, put them together and voilá! they have a brand new drug that they can sell you. With a large markup, of course.

Combination drugs can come in all shapes and sizes from pills to creams, have a look at these examples:

Combination Pills

An example of a combination pill is the weight loss pill Qsymia, which costs about $190 a month. Well, this drug is essentially just a combination of the drugs Topiramate and Phentermine.

If you were to buy the two ingredients together in their generic versions, you could get them for $9 and $8 each. Thus, you could cut the cost of your prescription from $190 to $17, just by doing your homework.

Is the drug different? In this case, not at all. What you’re paying for is essentially the doctor’s convenience to just write Qsymia on the prescription and for your own convenience to take one pill a day instead of two.

If the extra cost to take fewer pills is worth it to you, then, by all means, do it. But do it knowing what you’re paying for.

Supposedly, combination pills improve the likelihood that patients keep up with their medications and take the right dosage of each. But the real reason we have combination pills is to make a profit off of regulation.

Thanks to the FDA, a drug company can take two generic drugs, put them together and patent them as an entirely new combination drug.

Just as we saw with the case of Lovaza and Epidiolex, pharmaceutical companies invest billions of dollars to do this, because on the other side of it they can charge markups of 100x more for the same product.

Combination Creams

Another example of a combination drug is Xerese, a cream for cold sores and genital herpes lesions that helps to reduce the pain and speed up the resolution of the lesion.

Sounds nice, until you see the price at $1,200 a tube!

But, if you take the second to look at the ingredients, you’ll see that Xerese is really just a combination of acyclovir and hydrocortisone. For the two together, you’d be out around $100.

So, is the avoiding the complication of applying two creams to your lesion instead of one worth paying an extra $1,100 for the medication? Sure, it’s a bit of a hassle, but at that price difference, I think even a millionaire would choose the separate creams if they knew it was an option.

In a free market, a company might be able to get $20 more on a tube for the convenience factor, but there is no way they would be able to charge over $1,000 for it. But we’re not in a free market. Drug companies are able to charge these exorbitant prices because in most cases, consumers are not directly footing the bill for their prescription drugs. It’s the insurance companies are.

When you aren’t paying the full prices of your medications, you have little incentive to actually look at what you’re taking and to see if there are cheaper alternatives. That doesn’t mean that the cost just goes away. Instead, it’s just hidden away in your insurance premium.

While these artificially inflated prices might not immediately impact you if you’re passing off your prescription costs to your insurance company, it does keep prices higher for everyone else. And if you’re one of the millions of people living without insurance, you can certainly cut down your cost by following this advice and doing your homework.


To see if there are separate, generic alternatives to the medications you are taking, the best place to start is Google. Search the drug Xerese, for example, and you’ll see right on the manufacturer’s website the brand name, Xerese, and then in parentheses, it says acyclovir slash hydrocortisone.

In a glance, you can see that it’s a combination of two drugs. Then, you can look up the two drugs, see how much they cost and if you need a prescription. It’s very easy and you can do it in two or three minutes just by searching online.

As always, it’s recommended to run this by your doctor first. In fact, you might want to take a list of all your prescriptions to your doctor and simply ask what alternatives you have. It sounds like a no-brainer, but the number one reason that people overpay for their prescriptions is simply that they don’t question what they’ve been prescribed.

This information is intended to help readers be more informed about their health options when speaking with a professional, but it should not be used alone to diagnose, treat, prevent or cure any disease or condition. Be sure to speak to a qualified doctor before taking any action to make sure that your choices reflect your actual health situation.

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