How much does Olmesartan with HCTZ cost? $68 or $10?

Filed Under: Costs, Patients, Providers

olmesartan with hctz pill bottle

How much does Olmesartan with HCTZ cost? That depends. It could be $68 a month — or $10 a month.

My primary care physician prescribed Olmesartan with HCTZ (hydrochlorothiazide) as the next step to control rising blood pressure. She said both Olmesartan (Benicar) and HCTZ are generics, so the combination should not be too expensive.

Olmesartan is an angiotensin receptor blocker, which has not done the trick on its own, while HCTZ is a diuretic, supposed to cause your body to make more urine and thus get rid of extra salt and water. (So far, it’s not doing that, by the way.)

Well, guess what: You can buy that combination for $204 for three months, or for $30 a month for three months.

That’s right: $68 a month or $10 a month.

Price of Controlling blood pressure

First, you should know: For many people, controlling blood pressure with medications is not a one-and-done proposition; you might have to try many things. That’s been true so far with me. What does it mean to have “normal blood pressure,” anyway? And by the way, common medications can increase your blood pressure — never mind things like the pandemic — so how do you solve this problem?

My  primary care doctor (PCP), also known as a general practitioner (GP), and I have been working this problem for a while — see below — but here’s how it went down for me in the latest round. She sent the medication to the local pharmacy — which said that with my Medicare Part D insurance, the cost would be $204 for 90 days. I refused the prescription, because my doctor had said they were both generics.

olmesartan hctz price list
I looked up Olmedartan prices on GoodRX.com and indeed $204 is a high price in my area (see screenshot). Then I had a thought: We’ve been hearing about Mark Cuban Cost Plus Drugs, the online prescription seller bankrolled by the zillionaire Mark Cuban to make generic drugs available at low costs to people who choose not to use their insurance.

As we all know, the price of prescriptions is skyrocketing. But! The price of generics has no business skyrocketing, because they have been on the market for a long time and have no real patent protections.

However … the insurance system, fueled by pharmacy benefit managers, and the manufacturers over at Big Pharma, have found a way to make money on generics. That’s apparently what happened to me.

One tactic the manufacturers use is to combine two common generics into one pill, thereby making a “new” drug. So you could buy Olmesartan and HCTZ separately, and take two pills a day — or, for the ease of use you might find yourself where I was, with a prescription for the two combined into one pill.

Blood pressure medications: Amlodipine (norvasc), Benicar (olmesartan) etc.

For those keeping track at home, the meds prescribed to me include Norvasc (amlodipine, a calcium channel blocker that relaxes or widens blood vessels to improve blood flow) and Benicar (olmesartan medoxomil). My doctor has prescribed Amlodipine in two separate dosages (5 mg and 10 mg) resulting in edema and little effect on blood pressure; Lotrel, which combined amlodipine 5 with lisinopril 10   (edema, scratchy throat, little effect on blood pressure); Olmesartan (Benicar) which is an angiotensin receptor blocker (little effect, edema); and now Olmesartan with HCTZ a few weeks ago. The jury is still out on this one.

Benicar is a prescription blood pressure medication manufactured by Japanese drugmaker Daiichi Sankyo. Its active ingredient is olmesartan medoxomil,

It’s enough to make your blood pressure go up, pandemic or no.

Prices for medications, including blood pressure meds, vary a lot. We’ve written before about this: “How much does olmesartan-HCTZ (Benicar) cost, $771.99 or $6?” and “How much does Olmesartan (Benicar) cost? $11.05 or $45 or $76 or $159 or $601?” Also: “How much does Losartan cost? $6.43 or $13? $26.25 or $63?” and “How much does irbesartan cost?

My experience of bouncing among medications is not uncommon. Americans’ blood pressure readings are going up, statistics show, and medications to control the rise are sometimes hard to pick properly. Of course, lifestyle changes (more exercise and weight loss, for example) are better tools, but sometimes they’re hard to deploy. (Believe me, I’m trying.)

Meanwhile, picking the best medication includes test runs of several months to see if they 1) lower blood pressure, 2) have unacceptable side effects, 3) neither, or 4) both. This is not to mention a lot of complaining by me about how ineffective this whole process is, and how Big Pharma is making drugs that don’t do anything but cause side effects. Not to mention multiple explanations of this to doctors other than my GP about how yes, we’re working the problem, and no, it’s not been solved yet, and no, I don’t need you to interfere with my relationship with my GP.

Olmesartan cost with Mark Cuban Cost Plus Drugs

So that leads us to Mark Cuban Cost Plus Drugs. It is a not-so-new entrant into the pharmacy purchasing market in the United States.

It bills itself as a wholesaler, and as an answer to rising drug prices, for generics only, for now at least.

People who want to use this service must establish an online account, and get their doctor to send a prescription to this place and not to their local pharmacy. That took a few steps for me. I needed to:

1. Satisfy myself that this is a good choice. That took a little research. For example, you cannot use insurance at all — not private insurance, not Medicaid, not Medicare — with Cost Plus Drugs.
2. Let my GP know this was what I wanted to do, and to send her the page from the site explaining how to do it. That was an extra step or two.
Mark Cuban drugs pricing details

3. Wait for Cost Plus to email that they have the prescription.
4. Go back to my account and pay and ask them to ship, giving credit card etc.

I paid $15 for expedited shipping to the New York City area; bare bones would have been $5.

Things to know:
1. This does not work with your insurance.
2. The generics available are listed on the site. No others are available, though they promise to expand.
3. Some doctors are unenthusiastic about this as an option. Mine was fine with it. But it did take a little delay from running down to my corner pharmacy.

Publicity and marketing for Cost Plus Drugs

This Mark Cuban Cost Plus Drugs adventure began in 2021, judging from news reports, with Mark Cuban partnering with a doctor who is versed in this field. The business model doesn’t seem to be crystal clear right now, but Mark Cuban has enough money to worry about the business model later.

“Cholesterol medication Atorvastatin typically costs over $55, according to the Cuban-backed company’s website,” The Dallas Morning News reported. “Cost Plus charges $3.60. High blood pressure prescription Amlodipine usually runs around $50. Cost Plus lists it at $3.30.”

The initial rollout had a lot of publicity, and then it fell quiet. A new swath of publicity arrived earlier this year, accompanied by different attempt to make it seem brand new.

Promises are being made that the company will be not just a wholesaler but also a manufacturer.

While many people like me are saving money on generic drugs, others either don’t know that Cost Plus exists, or can’t get their doctor to send a prescription there. Beyond that, this affects only some generics, not all — and it doesn’t touch the brand-name drugs.

Also, Cost Plus doesn’t accept insurance, so there’s an uphill push to get patients to understand that cash prices can be much less than insurance prices. The existing system of rebates inside of the pharmacy purchasing system keeps a lot of people from even hearing about alternatives.

These costs will not apply to your deductible. For many people, the prices are so low that it doesn’t matter.

Competitors for low drug pricing

Amazon, which bought online pharmacy PillPack in 2018 for $753 million, launched its e-commerce drugstore Amazon Pharmacy in 2020. I have not tried it; people say great things about the Pillpack customer service. (Disclosure: I have a friend who was an early advisor to them, but he’s no longer there since the Amazon acquisition). You reportedly do not have to be an Amazon Prime member to use Pillpack.

A friend swears by his Drexi card. I have not tried this, but he’s sold.  Also, many pharmacies won’t accept discount coupons or cards but   some people we know who are in the health benefits world are saying they use Drexi for discounts. We are not endorsing, but mentioning. Let us know what you find out!

GoodRX is commonly used by people to check drug prices and shop around. They offer coupons; see above paragraph on coupons.

Finally, here’s our “how to save money on prescriptions” post.