Drug Prices 2025 vs 2026: What Pharmacies Actually Pay
Every week, the Centers for Medicare and Medicaid Services publishes the National Average Drug Acquisition Cost — what pharmacies across the country actually pay for each medication. We compared the full 2025 and 2026 NADAC datasets, covering more than 6,000 drugs, to see where prices dropped, where they climbed, and what it means for people paying out of pocket.
The Big Picture: More Drugs Got Cheaper Than Got Expensive
Across 6,132 drugs that appear in both the 2025 and 2026 NADAC datasets, the overall trend is modestly favorable for consumers. About 39% of drugs saw price decreases of more than 1%, while 35% saw increases of more than 1%. The remaining 26% held roughly steady.
The average price change across all drugs was a decrease of 2.1%. But the story is really two stories: generics and brands moved in opposite directions.
Generic drugs, which make up the bulk of the list at 4,335 tracked products, dropped 3.3% on average. Brand-name drugs, at 1,797 products, inched up 0.7% on average. That split matters because most Americans who pay out of pocket are filling generic prescriptions, and for them, the trend is heading the right direction.
The 20 Most Common Generics: Monthly Cost Comparison
These are the drugs that tens of millions of Americans take every day. Here is what pharmacies paid per month for a standard supply in 2025 versus 2026. These are acquisition costs, not retail prices — but they set the floor that every other price is built on top of.
| Drug (generic) | Used for | 2025 cost | 2026 cost | Change |
|---|---|---|---|---|
| Metformin 500 mg (60 tablets) | Type 2 diabetes | $0.85 | $0.84 | -0.6% |
| Metformin 1000 mg (60 tablets) | Type 2 diabetes | $1.38 | $1.34 | -2.9% |
| Lisinopril 10 mg (30 tablets) | Blood pressure | $0.56 | $0.56 | -0.6% |
| Lisinopril 20 mg (30 tablets) | Blood pressure | $0.79 | $0.77 | -1.8% |
| Atorvastatin 20 mg (30 tablets) | Cholesterol | $0.89 | $0.84 | -5.7% |
| Amlodipine 5 mg (30 tablets) | Blood pressure | $0.43 | $0.43 | -0.5% |
| Omeprazole 20 mg (30 capsules) | Acid reflux | $1.28 | $1.20 | -6.7% |
| Losartan 50 mg (30 tablets) | Blood pressure | $0.77 | $0.74 | -3.4% |
| Gabapentin 300 mg (90 capsules) | Nerve pain | $3.06 | $2.77 | -9.4% |
| Sertraline 50 mg (30 tablets) | Depression | $1.16 | $1.04 | -10.5% |
| Levothyroxine 50 mcg (30 tablets) | Thyroid | $1.68 | $1.48 | -12.1% |
| Amoxicillin 500 mg (30 capsules) | Antibiotic | $2.72 | $2.33 | -14.1% |
| Escitalopram 10 mg (30 tablets) | Anxiety | $1.29 | $1.17 | -8.8% |
| Rosuvastatin 10 mg (30 tablets) | Cholesterol | $1.20 | $1.14 | -4.9% |
| Pantoprazole 40 mg (30 tablets) | Acid reflux | $1.23 | $1.16 | -5.8% |
The takeaway here is reassuring. If you are taking any of the most common generics in America, your pharmacy is paying less for them this year than last year. Every single one of the top 15 either held steady or dropped. Gabapentin, sertraline, amoxicillin, and levothyroxine all fell by roughly 10% or more.
These are already inexpensive drugs — we are talking about monthly acquisition costs under $3 in most cases. But the direction matters. In a market where drug prices make headlines for going up, the generic staples that most people actually take are quietly getting cheaper.
Insulin: The Biggest Price Drops in the Entire Dataset
The most dramatic price changes in the 2025-to-2026 NADAC data are in insulin. Several brand-name insulins saw their pharmacy acquisition costs fall by 70% to 75%, making them some of the largest single-year price drops for any drug in the dataset.
| Insulin product | 2025 per mL | 2026 per mL | Change |
|---|---|---|---|
| Fiasp (Novo Nordisk) vial | $27.73 | $6.92 | -75.0% |
| Tresiba FlexTouch 100 U/mL | $32.52 | $9.04 | -72.2% |
| Humalog KwikPen 200 U/mL | $67.76 | $20.32 | -70.0% |
| Lyumjev (Lilly) vial | $26.30 | $7.88 | -70.0% |
| Biosimilar Glargine pen | $5.92 | $2.90 | -51.0% |
| Humalog (Lilly) vial | $6.36 | $6.36 | 0.0% |
| NovoLog (Novo) vial | $6.94 | $6.94 | 0.0% |
| Lantus SoloStar pen | $6.17 | $6.17 | 0.0% |
| Generic Lispro vial | $2.41 | $2.40 | -0.1% |
These drops are not random. They reflect the combination of Inflation Reduction Act provisions, manufacturer voluntary price cuts, and increased biosimilar competition in the insulin market. Novo Nordisk slashed the list prices of Fiasp and Tresiba in late 2025, and Eli Lilly did the same for Humalog KwikPen and Lyumjev. Those list price cuts are now showing up in what pharmacies actually pay.
The insulins that were already cheap — like the Humalog and NovoLog vials that had already dropped to around $6-7 per mL in the 2023-2024 price cuts — held steady. They were already at the floor. The big drops hit the premium delivery formats (FlexTouch pens, KwikPens) and newer formulations that had been holdouts.
For the 8.4 million Americans who use insulin, this is the most significant pricing shift in years. The acquisition cost gap between brand-name pens and generic vials has narrowed dramatically.
GLP-1 Drugs: Still Expensive, Barely Moved
If you were hoping for relief on Ozempic, Wegovy, Mounjaro, or Zepbound pricing, the NADAC data does not deliver good news. These drugs — used for diabetes and weight loss — saw almost no movement in what pharmacies pay.
| Drug | 2025 per unit | 2026 per unit | Change |
|---|---|---|---|
| Ozempic 1 mg pen (per mL) | $322.32 | $331.89 | +3.0% |
| Wegovy 2.4 mg pen (per mL) | $435.47 | $435.57 | +0.0% |
| Mounjaro 15 mg pen (per mL) | $522.95 | $538.46 | +3.0% |
| Zepbound 15 mg pen (per mL) | $525.92 | $526.05 | +0.0% |
| Rybelsus 14 mg tablet | $32.21 | $33.16 | +3.0% |
| Trulicity 1.5 mg pen (per mL) | $478.07 | $487.53 | +2.0% |
The GLP-1 class remains the most expensive category of commonly prescribed drugs in the United States. A month of Ozempic costs a pharmacy roughly $900 at acquisition, and Wegovy runs over $1,300. These drugs have no generic competition yet, and Novo Nordisk and Eli Lilly have shown no inclination to cut list prices the way they did with insulin.
For context, a month of metformin — the first-line diabetes drug — costs a pharmacy about 84 cents. A month of Ozempic costs about 1,070 times more at acquisition. Whether that premium is justified by clinical outcomes is a question for your doctor. What the NADAC data tells us is that the premium is not shrinking.
Surprise Winners: Drugs That Got Dramatically Cheaper
Some of the biggest price drops in the dataset come from drugs that recently lost patent protection or gained new generic competitors.
| Drug | 2025 per unit | 2026 per unit | Change | Why |
|---|---|---|---|---|
| Dapagliflozin 10 mg (Farxiga generic) | $11.43 | $0.20 | -98.2% | New generics entered market |
| Ticagrelor 60 mg (Brilinta generic) | $5.71 | $0.31 | -94.6% | Patent expiration + generic flood |
| Eliquis 2.5 mg | $9.69 | $5.51 | -43.1% | Competitive pressure |
| Jardiance 10 mg | $20.13 | $11.19 | -44.4% | Market competition |
| Sertraline 150 mg capsule | $5.04 | $1.70 | -66.3% | Additional generic suppliers |
| Azithromycin 600 mg | $1.47 | $0.79 | -46.3% | Increased manufacturing |
The dapagliflozin story is particularly striking. This is the generic version of Farxiga, an SGLT2 inhibitor used for type 2 diabetes and heart failure. A year ago, pharmacies were paying over $11 per tablet. Today, after multiple generic manufacturers entered the market, the acquisition cost has collapsed to about 20 cents. That is a 98% drop.
Eliquis and Jardiance — two of the most expensive commonly prescribed brand-name drugs — also saw significant drops. Neither has a generic available yet, which makes the drops unusual. They appear to reflect competitive pricing pressure and possibly early positioning ahead of expected generic entry.
What Went Up: Drugs That Got More Expensive
Not everything moved in the right direction. A handful of drugs saw notable price increases, though the increases tended to be concentrated in niche products rather than high-volume prescriptions.
Clemastine, an older antihistamine, jumped 560% — but it started at 50 cents per tablet, so even the new price of $3.31 is not burdensome for most patients. Imiquimod 3.75% cream (used for skin conditions) rose 351%, and erythromycin eye ointment doubled. These are cases where limited manufacturer interest in low-volume generics allows prices to drift upward without competitive correction.
Among high-profile drugs, Dupixent (used for eczema and asthma) rose 5.3%, and Adderall 30 mg rose 9.8%. Both are brand-name products with limited or no generic competition.
What This Means for People Paying Out of Pocket
NADAC is what pharmacies pay, not what you pay. But the two are connected. When acquisition costs drop, discount card prices follow — usually within a few weeks. Here is what consumers should take from this data.
If you take common generics — blood pressure pills, statins, metformin, SSRIs, thyroid medication — your drugs are getting cheaper at the wholesale level. Use a discount card to make sure your pharmacy passes those savings along. A pharmacy paying 84 cents for your monthly metformin supply should not be charging you $15 for it.
If you use insulin, check your options. The price drops on Tresiba, Fiasp, Humalog KwikPen, and Lyumjev are substantial. If your pharmacy has not adjusted its cash prices to reflect the new acquisition costs, switch to one that has. Costco, Walmart, and Cost Plus Drugs tend to price closer to acquisition cost than traditional chain pharmacies.
If you take a GLP-1 drug, the pricing picture has not changed. Ozempic and Wegovy remain in the $900 to $1,300 per month range at acquisition cost. Without insurance or a manufacturer coupon, these drugs remain out of reach for most cash-pay patients. The best option is still the manufacturer savings card programs — Novo Nordisk and Eli Lilly both offer copay assistance that can reduce out-of-pocket costs significantly for eligible patients.
About the Data
All figures in this article come from the CMS National Average Drug Acquisition Cost (NADAC) datasets for calendar years 2025 and 2026. NADAC surveys pharmacy invoices weekly to determine the national average cost of acquiring each drug. The 2026 dataset used here is current through August 12, 2026, and contains 6,327 unique drug products. The 2025 dataset is the full calendar year and contains 6,692 products.
NADAC data is published by the Centers for Medicare and Medicaid Services and is freely available at data.medicaid.gov. For the methodology behind how NADAC is calculated, see the CMS NADAC overview page.
Disclaimer: RxGator provides drug pricing information for educational purposes only. Prices shown are acquisition costs, not consumer prices. Actual pharmacy prices vary by location, pharmacy, discount program, and insurance status. This is not medical advice. Always consult your healthcare provider about medication decisions.