Prescription drug, same dose as OTC - why? (and why cheaper?)

My husband wound up getting a written prescription for omeprazole (generic Prlosec) capsules, 20 mg dose. Sort of accidentally (his internist was writing scrips for everything he had listed as taking), but when he saw it in the pile of papers, he mailed it off.

Turns out the total cost was something like 28 dollars for a 90-day supply. The over-the-counter version would work out to 32 dollars for the same amount, in tablet form.

My own insurance has an even better price on the same drug (I got wise, and just asked for a scrip from my gastro yesterday; we both use it long-term): something like 16 dollars. Cheaper third-world supplier, I guess.

Ok, admittedly these are mail-order prices, and someone paying “list” might pay more than that.

The questions are:

  1. Anyone know why they even sell the prescription version when OTC is available at the same dose? Is there something magical about the capsules?
  2. Why is the prescription that much cheaper?

My WAG: if it’s a prescription drug, your insurance will pay for it. Can’t do that with OTC. As far as the pricing, who knows? I’m guessing it goes through an entirely different sales channel than the OTC version so vastly different pricing isn’t surprising.

Right, insurance will pay if it’s a prescription - but I’m surprised they’ll pay for something that’s available OTC at the same dosage.

It happens all the time in Canada. Often, I’ll write prescriptions for OTC Xantac so people pay less than if they got it over the counter. It’s also nice because it makes the drug seem more “medicinal” and improves treatment adherence.

ETA: cheaper if they’re covered by a private drug plan, I mean.

Lower packaging costs?

Huh - could be. And better packaging. Those (very bad word) blister packs are such a huge pain. We’ve been buying the brand-name because their blister-packs don’t require tactical nukes to pry open. It’ll be nice to be able to just pop open a bottle.

My insurance will give me Prilosec, Zyrtec and 3 other things I can’t think off for free on their zero tier program. Same doses as what I would get right off the shelf. I should also mention that this is a high deductible plan so most of my scripts I have to pay full price for, but these are free, I just have to have a doctor call the prescription in.

I think the idea is that they would rather you get free Prilosec then ignore your heartburn and end up with ulcers and have to get your stomach scoped. They would rather you get free Zyrtec for your allergies then then go see a ENT or Allergist and get allergy shots or go on Nasonex.