PlainMeds research, FDA and CMS files of October 8, 2026
The largest changes in what pharmacies pay, over 12 months
Of 3,213 NADAC descriptions priced a year apart, 1,010 rose and 2,151 fell; the largest rise is Imiquimod 3.75% cream pump (+363.8%) and the largest fall Dapagliflozin 5 mg tablet (-98.6%). Of the 20 largest falls, 7 are medicines whose first generic was approved in the last two years (Drugs@FDA): a generic entering the market is the usual reason a price drops this far.
Which prices rose most?
| Medicine | Description | Brand or generic | Year earlier ($ per unit) | Now ($ per unit) | Change (%) |
|---|---|---|---|---|---|
| Imiquimod | Imiquimod 3.75% cream pump | Generic | $24.39 | $113.12 | +363.8 |
| Water | Water for injection vial | Generic | $0.1008 | $0.315 | +212.5 |
| Alclometasone | Alclometasone dipro 0.05% cream | Generic | $0.5721 | $1.57 | +174.1 |
| Verapamil | Verapamil ER 120 mg capsule | Generic | $1.02 | $2.75 | +168.9 |
| Memantine | Memantine HCl 2 mg/mL solution | Generic | $0.3971 | $0.8106 | +104.1 |
| Benzoyl peroxide and tretinoin | Twyneo 0.1%-3% cream pump | Brand | $15.66 | $31.66 | +102.2 |
| Potassium chloride | Klor-con m20 tablet | Brand | $0.0712 | $0.1422 | +99.8 |
| Lorazepam | Lorazepam 2 mg/mL vial | Generic | $1.09 | $2.17 | +99.4 |
| Voriconazole | Voriconazole 50 mg tablet | Generic | $0.4379 | $0.8275 | +89.0 |
| Naproxen | Naproxen DR 375 mg tablet | Generic | $1.25 | $2.23 | +78.1 |
| Fentanyl | Fentanyl 100 mcg/2 mL vial | Generic | $1.01 | $1.79 | +76.3 |
| Fentanyl | Fentanyl 2,500 mcg/50 mL vial | Generic | $1.01 | $1.79 | +76.3 |
| Fentanyl | Fentanyl 250 mcg/5 mL vial | Generic | $1.01 | $1.79 | +76.3 |
| Codeine and promethazine | Promethazine-codeine solution | Generic | $0.0406 | $0.0697 | +71.6 |
| Sotalol | Sotalol 240 mg tablet | Generic | $0.1168 | $0.2006 | +71.6 |
| Acetylcysteine | Acetylcysteine 20% vial (not for injection) | Generic | $1.32 | $2.25 | +70.3 |
| Diethylpropion | Diethylpropion ER 75 mg tablet | Generic | $1.21 | $1.91 | +58.5 |
| Acetylcysteine | Acetylcysteine 10% vial (not for injection) | Generic | $1.68 | $2.55 | +52.1 |
| Clomiphene | Clomid 50 mg tablet | Brand | $11.01 | $16.74 | +52.1 |
| Fluoxetine and olanzapine | Olanzapine-fluoxetine 12-25 mg | Generic | $6.64 | $9.93 | +49.6 |
| Dexamethasone | Dexamethasone 20 mg/5 mL vial | Generic | $0.1598 | $0.2381 | +49.0 |
| Vardenafil | Vardenafil HCl 5 mg tablet | Generic | $4.78 | $7.10 | +48.5 |
| Captopril | Captopril 25 mg tablet | Generic | $0.1178 | $0.1728 | +46.7 |
| Doxycycline | Doxycycline hyclate 75 mg tablet | Generic | $0.3816 | $0.5482 | +43.6 |
| Carvedilol | Carvedilol ER 20 mg capsule | Generic | $4.73 | $6.74 | +42.5 |
| Duloxetine | Duloxetine HCl DR 60 mg capsule | Generic | $0.0949 | $0.1349 | +42.2 |
| Rifampin | Rifampin 150 mg capsule | Generic | $0.6313 | $0.8978 | +42.2 |
| Potassium chloride | Klor-con m15 tablet | Brand | $0.3509 | $0.496 | +41.3 |
| Fondaparinux | Fondaparinux 10 mg/0.8 mL syringe | Generic | $31.82 | $44.82 | +40.9 |
| Paricalcitol | Paricalcitol 2 mcg capsule | Generic | $1.85 | $2.59 | +40.2 |
Which prices fell most?
| Medicine | Description | Brand or generic | Year earlier ($ per unit) | Now ($ per unit) | Change (%) |
|---|---|---|---|---|---|
| Dapagliflozin | Dapagliflozin 5 mg tablet | Generic | $11.60 | $0.1627 | -98.6 |
| Dapagliflozin | Dapagliflozin 10 mg tablet | Generic | $11.51 | $0.1839 | -98.4 |
| Prucalopride | Prucalopride 2 mg tablet | Generic | $13.16 | $0.619 | -95.3 |
| Ticagrelor | Ticagrelor 60 mg tablet | Generic | $5.98 | $0.2821 | -95.3 |
| Prucalopride | Prucalopride 1 mg tablet | Generic | $12.61 | $0.6393 | -94.9 |
| Dapagliflozin and metformin | Dapagliflozin-metformin ER 10-1,000 mg tablet | Generic | $11.86 | $0.7195 | -93.9 |
| Dapagliflozin and metformin | Dapagliflozin-metformin ER 5-1,000 mg tablet | Generic | $5.89 | $0.4606 | -92.2 |
| Sodium chloride | Sodium chloride 0.9% solution | Generic | $0.0262 | $0.0021 | -92.1 |
| Miconazole | Miconazole 3 combo pack | Generic | $4.27 | $0.4132 | -90.3 |
| Dasatinib | Dasatinib 100 mg tablet | Generic | $191.74 | $26.46 | -86.2 |
| Rivaroxaban | Rivaroxaban 2.5 mg tablet | Generic | $3.39 | $0.6496 | -80.8 |
| Temozolomide | Temozolomide 20 mg capsule | Generic | $4.11 | $0.8798 | -78.6 |
| Sertraline | Sertraline 150 mg capsule | Generic | $5.17 | $1.25 | -75.8 |
| Ivabradine | Ivabradine HCl 7.5 mg tablet | Generic | $2.60 | $0.64 | -75.4 |
| Ivabradine | Ivabradine HCl 5 mg tablet | Generic | $3.02 | $0.7607 | -74.8 |
| Saxagliptin | Saxagliptin HCl 5 mg tablet | Generic | $3.94 | $1.04 | -73.6 |
| Fingolimod | Fingolimod 0.5 mg capsule | Generic | $5.56 | $1.58 | -71.6 |
| Estradiol | Estradiol 0.1% (0.75 mg) gel pk | Generic | $2.07 | $0.5919 | -71.4 |
| Abiraterone | Abiraterone acetate 500 mg tablet | Generic | $9.01 | $2.59 | -71.2 |
| Allopurinol | Allopurinol 200 mg tablet | Generic | $6.16 | $1.84 | -70.1 |
| Teriflunomide | Teriflunomide 14 mg tablet | Generic | $0.7368 | $0.2334 | -68.3 |
| Saxagliptin | Saxagliptin HCl 2.5 mg tablet | Generic | $3.60 | $1.14 | -68.2 |
| Tolvaptan | Tolvaptan 15 mg tablet | Generic | $45.69 | $14.57 | -68.1 |
| Sertraline | Sertraline 200 mg capsule | Generic | $5.18 | $1.74 | -66.5 |
| Gabapentin | Gabapentin ER 300 mg tablet | Generic | $1.89 | $0.6385 | -66.2 |
| Timolol | Timolol 0.25% gel-solution | Generic | $18.46 | $6.38 | -65.5 |
| Tetracycline | Tetracycline 250 mg capsule | Generic | $0.7024 | $0.2472 | -64.8 |
| Venlafaxine | Venlafaxine HCl ER 75 mg tablet | Generic | $0.8071 | $0.2852 | -64.7 |
| Formoterol | Formoterol 20 mcg/2 mL neb vial | Generic | $3.68 | $1.30 | -64.5 |
| Methotrexate | Methotrexate 250 mg/10 mL vial | Generic | $1.94 | $0.702 | -63.9 |
Source: CMS National Average Drug Acquisition Cost (NADAC) weekly files, data.medicaid.gov, read October 8, 2026
How it was measured
The newest NADAC weekly file against the observation nearest to 12 months earlier (within 45 days), per description, for descriptions carried by two or more NDCs.
What it cannot show
NADAC is a survey average and moves with wholesaler prices; a single-NDC description is left out because one product moves it alone.