Quite possibly. The Q1Medicare® Q1Rx® Drug Finder (
Q1Rx.com) shows all
Medicare Part D plans or
Medicare Advantage plans in a
Service Area (state, county or ZIP code) providing coverage for a
particular formulary drug and (when available) the average retail price for the drug across all of the Medicare drug plan's network pharmacies (preferred and standard) within the specific Service Area.
In many cases, the average negotiated retail price
shown in the Q1Rx Drug Finder accurately reflects what you may find at your chosen network pharmacy.
But remember, retail drug prices can change regularly, even changing on a weekly-basis - and prices can vary pharmacy-to-pharmacy - and drug prices can vary between your plan's standard and preferred network pharmacies - and retail drug prices
can even vary between your plan's preferred network pharmacies.
In addition, retail drug pricing data is updated on a regular basis, and your actual retail drug price depends on how your Medicare prescription drug plan (
PDP or MAPD) has negotiated with the standard and preferred network pharmacies in your area - and how that retail price has changed over the past weeks.
For example, if you are using our
Q1Rx.com Drug Finder, you might see the following information for the common generic drug
"Atorvastatin 10mg" when searching across all stand-alone California Medicare Part D plans (PDPs).
In this older example, you can see in the results below that one
Medicare Part D plan has an average negotiated retail price of $26.89
and another plan has an average negotiated retail price of $5.67 - for
the exact same 10mg Atorvastatin drug.
When looking at retail drug prices, you may even find that retail drug
prices vary between Medicare Part D plans offered by the same company.
As shown in
the graphic below
(Q1Rx.com/2020/FL/60505015801), you can see that several Medicare Part D
plans offered by the same company have different average negotiated
retail drug prices for the same drug (BUPROPION HCL 75 MG TABLET
(100.000 EA) (NDC: 60505015801)).
Important: The "average drug price" may not take into account wide retail pricing variations between different pharmacies.
By definition the "average price" can be very close to the actual
retail price you find at a pharmacy - or the variation in pricing can be pretty broad - depending on a
Medicare Part D prescription drug plan's pricing strategy.
In the table below we show "Example Drug ABCD" and how four
different Medicare Part D plans can all have an average negotiated
retail price of $50, but the actual retail drug prices found at the
three different example pharmacies can vary widely from $7 to $95.
In our example, if you saw a retail drug price of $50 "average retail
drug price" - this price would be close to the actual pharmacy pricing
found on Drug Plan 1 and Drug Plan 4 (with the lowest variation between Pharmacies #1, #2, and #3).
But the $50 "average drug pricing" would not closely represent actual pricing at all three pharmacies for Drug Plan 2 and Drug Plan 3 - the three example pharmacies have wide variations in retail price depending on the plan - but the average price is still $50.
"Example
Drug ABCD" |
Pharmacy
#1 |
Pharmacy
#2 |
Pharmacy
#3 |
"Average"
Price
|
Drug Plan 1 |
$50 |
$50 |
$50 |
$50 |
Drug Plan 2 |
$7 |
$60 |
$83 |
$50 |
Drug Plan 3 |
$15 |
$40 |
$95 |
$50 |
Drug Plan 4 |
$45 |
$50 |
$55 |
$50 |
Bottom Line: Average pricing may not always equal actual drug prices.
So what can we learn about average retail drug pricing?
- You might find that your actual retail drug prices will vary
depending on the pharmacy you use as drug prices can vary
pharmacy-to-pharmacy - and retail prices can even vary between preferred
network pharmacies.
- And naturally, "standard" network pharmacy pricing may not be the same as "preferred" pharmacy pricing.
- Retail drug prices change all the time - and can even change on
a weekly-basis - your drug plan should have the most accurate retail
drug price information, but often this information is not updated
regularly on the plan's website).
- During the annual Open Enrollment Period (AEP that starts
October 15th and continues through December 7th) our retail drug pricing
data is for the time period through September - but, we often find that
some Medicare prescription drug plans have already changed their retail
drug prices for the following year (for example, a medication may have a
2020 retail price of $7, but can have a 2021 retail price of $47 - same
drug, same plan, same pharmacy).
- So, if you are choosing a Medicare plan during the AEP, contact
the Medicare Part D prescription drug plan or Medicare (1-800-Medicare)
for more specific pricing at your chosen pharmacy - then check the retail drug prices again
before the December 7th close of the annual Open Enrollment Period to
ensure that the retail prices have remained stable and that your chosen
Medicare plan is still providing the most economic coverage.