# Why is cough medicine so expensive compared to other OTC drugs?
**URL:** https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759
**Category:** Factual Questions
**Created:** [March 28, 2023, 5:37am UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759 "2023-03-28T05:37:58Z")
**Posts on this page:** 20
**Page:** 1
### Author:  [@Spectre\_of\_Pithecanthropus](https://boards.straightdope.com/u/Spectre_of_Pithecanthropus)
#### Post date: [March 28, 2023, 5:37am UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/1 "2023-03-28T05:37:59Z")
(And of course by cough medicine I mean something that actually contains an active antitussive ingredient, as opposed to so-called “cough drops” that are really just candy.)
I was just doing an informal survey of OTC meds on the website of the local big box store. To say the least, typical prices vary wildly depending on what you’re looking for.
The generic equivalents of Tylenol and Benadryl cost only a few pennies per dose. Generic Claritin and Zyrtec are a bit more expensive, but still come in under ten cents for a typical adult dose.
Generic drugs for GI problems like diarrhea and gas cost a bit more, but still under 15c per dose.
On the other hand, Robitussin DXM gelcaps, at $6 for a box of 20, come out to 60c for the recommended adult dose. That’s if and when I can find it, which I usually can’t.
And the DXM polistirex suspension (genetic equivalent of Delsym) comes in at 56c a dose. Often, this is the only single ingredient DXM preparation available, but even so I’ve never used it. I prefer not to take anything that contains actual microplastic.
So, why the variation in price? Why does a dose of cough medicine cost nearly 10 times as much as a dose of first generation antihistamine?
TBT it could be as regional thing; when I lived in California I could find 4-ounce bottles of generic DXM syrup at the dollar store, but I’ve never seen anyrhing like that in Oregon.
---
### Author:  [@excavating\_for\_a\_mind](https://boards.straightdope.com/u/excavating_for_a_mind)
#### Post date: [March 28, 2023, 1:13pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/2 "2023-03-28T13:13:30Z")
When someone asks, “Why does XXX cost more than YYY?” the usual response is couched around a (supposed) fact that XXX costs more to produce. The truth is much simpler than that.
The product XXX costs $ZZ.ZZ because that is what people are willing to pay for it. Another way of looking at it is because $ZZ.ZZ is the lowest amount that those who have XXX are willing to accept. It really is that simple.
Of course, if it costs more than $ZZ.ZZ to produce XXX, you won’t find many people willing to sell it for $ZZ.ZZ.
---
### Author:  [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)
#### Post date: [March 28, 2023, 1:15pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/3 "2023-03-28T13:15:18Z")
Here is some info that suggests an answer:
> Throat lozenges, cough mixtures and some painkillers are among the over-the-counter medicines in short supply, according to the Association of Independent Multiple Pharmacies.
>
> The industry group warned of supply issues of both branded and unbranded medicines to treat seasonal illnesses.
>
> - SOURCE: [Pharmacy bosses warn over shortage of cough and cold medicines amid ‘high level’ of winter illnesses](https://news.sky.com/story/pharmacy-bosses-warn-over-shortage-of-cough-and-cold-medicines-12779730)
The above story is from Great Britain but it seems the same in the US too:
> U.S. households are stepping up spending on cough and cold medicines and children’s pain relievers amid a rise in reports of respiratory infections, leading to sporadic shortages of some drugs online and at stores.
>
> Flu infections and hospitalizations are surging across the country, federal data suggests, on top of an already busy season for other respiratory viruses including respiratory syncytial virus, or RSV. These viruses are common in the fall and winter months, but the sharp, early increases have roiled families and put pressure on children’s hospitals.
>
> - SOURCE: [Why You Might Be Having Trouble Buying Children’s Flu and Cold Medicine](https://www.wsj.com/articles/cold-cough-drugs-in-short-supply-in-some-areas-as-families-fight-flu-rsv-and-covid-11671075522)
---
### Author:  [@aruvqan](https://boards.straightdope.com/u/aruvqan)
#### Post date: [March 28, 2023, 7:10pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/4 "2023-03-28T19:10:44Z")
Never understood cough drops - especially the ones with menthol and what not. I guess it is not a flavor profile I like.
I always did hot tea with lemon and honey or ginger lemon tea with honey [if I didn’t want the caffeine of black tea] and I use a facial steamer to generate the steam for my sinuses, and I have used neti pot for years [I have noticed, neti poting seems to keep the old 2 to 3 times a winter colds away.]
---
### Author:  [@wguy123](https://boards.straightdope.com/u/wguy123)
#### Post date: [March 28, 2023, 8:42pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/5 "2023-03-28T20:42:41Z")
> [@Spectre\_of\_Pithecanthropus](#):
>
> I prefer not to take anything that contains actual microplastic.
Huh? I’m dumb in this arena, but there is medicine that contains plastics?
BTW, I tried googling this and the first result is this thread.
As far as the factual question goes, I don’t know so I hope my question about plastics is OK.
---
### Author:  [@Spectre\_of\_Pithecanthropus](https://boards.straightdope.com/u/Spectre_of_Pithecanthropus)
#### Post date: [March 29, 2023, 2:15am UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/6 "2023-03-29T02:15:17Z")
> [@wguy123](#):
>
> Huh? I’m dumb in this arena, but there is medicine that contains plastics?
Indeed. DXM [polistirex](https://en.wikipedia.org/wiki/Delsym?wprov=sfla1) is DXM globules surrounded by an edible plastic as part of its extended release mechanism.
---
### Author:  [@Spectre\_of\_Pithecanthropus](https://boards.straightdope.com/u/Spectre_of_Pithecanthropus)
#### Post date: [March 29, 2023, 2:32am UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/7 "2023-03-29T02:32:50Z")
> [@excavating\_for\_a\_mind](#):
>
> The product XXX costs $ZZ.ZZ because that is what people are willing to pay for it. Another way of looking at it is because $ZZ.ZZ is the lowest amount that those who have XXX are willing to accept. It really is that simple.
Is it really?
Eugene has grass farms in the area (real grass for sod, not marijuana) and is famous for the amount of pollen that floats around in the air. Believe me, people around here would be willing to pay a lot more than four cents per Benadryl tablet, but they’re not being forced to do so.
---
### Author:  [@wguy123](https://boards.straightdope.com/u/wguy123)
#### Post date: [March 29, 2023, 2:33am UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/8 "2023-03-29T02:33:50Z")
Dang! We are even ingesting single use plastics. Sad.
---
### Author:  [@Spectre\_of\_Pithecanthropus](https://boards.straightdope.com/u/Spectre_of_Pithecanthropus)
#### Post date: [March 29, 2023, 2:47am UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/9 "2023-03-29T02:47:49Z")
According to the Wiki article, the polistirex does fully degrade in the stomach, so it’s not like we can liken it to a plastic water bottle that ends up in a landfill.
I don’t like the polistirex version because it’s so thick and viscous it feels like it gets stuck in my throat. Also, I don’t need something that works for twelve hours so that doesn’t justify the price, at least for me.
---
### Author:  [@jjakucyk](https://boards.straightdope.com/u/jjakucyk)
#### Post date: [March 29, 2023, 1:17pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/10 "2023-03-29T13:17:15Z")
> [@aruvqan](#):
>
> Never understood cough drops - especially the ones with menthol and what not. I guess it is not a flavor profile I like.
>
> I always did hot tea with lemon and honey or ginger lemon tea with honey [if I didn’t want the caffeine of black tea] and I use a facial steamer to generate the steam for my sinuses, and I have used neti pot for years [I have noticed, neti poting seems to keep the old 2 to 3 times a winter colds away.]
Those are fine if you’re at home but not at the office or on the road. Coughs tend to linger on past the point where you’re otherwise feeling fine, or they’re sometimes the only symptom, so not much point in staying in bed.
> [@Spectre\_of\_Pithecanthropus](#):
>
> According to the Wiki article, the polistirex does fully degrade in the stomach, so it’s not like we can liken it to a plastic water bottle that ends up in a landfill.
I tend to agree, and I wonder if it’s even really a plastic, or that’s just a quick and easy descriptor? I don’t have the time to look it up at the moment. There’s degradable corn-based plastics out there too.
---
### Author:  [@excavating\_for\_a\_mind](https://boards.straightdope.com/u/excavating_for_a_mind)
#### Post date: [March 29, 2023, 1:34pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/11 "2023-03-29T13:34:59Z")
> [@Spectre\_of\_Pithecanthropus](#):
>
> > [@excavating\_for\_a\_mind](#):
> >
> > The product XXX costs $ZZ.ZZ because that is what people are willing to pay for it. Another way of looking at it is because $ZZ.ZZ is the lowest amount that those who have XXX are willing to accept. It really is that simple.
>
> Is it really?
>
> Eugene has grass farms in the area (real grass for sod, not marijuana) and is famous for the amount of pollen that floats around in the air. Believe me, people around here would be willing to pay a lot more than four cents per Benadryl tablet, but they’re not being forced to do so.
Yes, it is, really.
Your example is flawed in that nobody is forcing anybody to buy Benadryl at any price. It is the consumer who makes the decision to purchase and how much to pay. As long as there are retailers in the area willing to sell it for 4 cents a tablet, those trying to get more find they don’t have many customers.
If you are implying that the manufactures of Benadryl could increase their price to the wholesalers to make a bigger profit, the manufacturers have a sales group (likely called Marketing) whose job it is to determine the price in the marketplace that will result in the highest profit. While the pollen in the air in Eugene probably figures into the calculus, it is already baked into the 4 cents a tablet retail price.
---
### Author:  [@bump](https://boards.straightdope.com/u/bump)
#### Post date: [March 29, 2023, 2:46pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/12 "2023-03-29T14:46:51Z")
Put another way, the retailers of the product will set the price where they think it’ll generate the most revenue (i.e. the most money). That’s a balancing act between selling a lot at a lower price per unit and selling fewer at a higher price.
Every product has its sweet spot with respect to those factors.
The _cost_ of the product doesn’t have anything at all to do with the price. It’s entirely possible that a product may be dirt cheap to produce, and yet still be priced pretty high. Case in point- beer. Malted barley, water, hops and yeast are pretty cheap all things considered.
[Here’s How A Six-Pack Of Craft Beer Ends Up Costing $12 | HuffPost Life](https://www.huffpost.com/entry/craft-beer-expensive-cost_n_5670015)
(their example actually adds up to 101% 😬)
So by that, the actual ingredients and production costs make up 24% of the total cost of a six-pack of craft beer. Around $2.50-$3 these days ($2.88 in the HuffPo example) . The rest is profit, marketing, shipping, tax, etc… in particular the distributor and retailer margins make up 52% of the total cost.
And I’d bet they don’t have any visibility into the actual cost of ingredients, etc… past the fact that the brewer has priced their beers at $5.04 per six pack / distributor prices at $7.56 per six-pack. They add their markups based on whatever it is that _they’re_ trying to do in terms of profitability/sales targets/etc…
---
### Author:  [@Thudlow\_Boink](https://boards.straightdope.com/u/Thudlow_Boink)
#### Post date: [March 29, 2023, 3:31pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/13 "2023-03-29T15:31:19Z")
> [@excavating\_for\_a\_mind](#):
>
> When someone asks, “Why does XXX cost more than YYY?” the usual response is couched around a (supposed) fact that XXX costs more to produce. The truth is much simpler than that.
You do have a good point here. Many people seem to think that the retail price of something necessarily is, or should be, directly proportional to its cost to manufacture. (And, as a corollary, that price is always a reliable guide to quality.). However…
> [@excavating\_for\_a\_mind](#):
>
> The product XXX costs $ZZ.ZZ because that is what people are willing to pay for it. Another way of looking at it is because $ZZ.ZZ is the lowest amount that those who have XXX are willing to accept. It really is that simple.
While I agree this is truer, I don’t think it’s simpler. (“The truth is rarely pure and never simple.” -Oscar Wilde) It still leaves open the question of _why_ $ZZ.ZZ is the amount that people are willing to pay to buy, or accept to sell, the item. And there may be many factors, including but not limited to manufacturing costs, that influence this.
---
### Author:  [@Awb78](https://boards.straightdope.com/u/Awb78)
#### Post date: [March 29, 2023, 10:11pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/14 "2023-03-29T22:11:52Z")
Advertising.
Plus the Name Brands did the legwork on research before the generics were available.
---
### Author:  [@Spectre\_of\_Pithecanthropus](https://boards.straightdope.com/u/Spectre_of_Pithecanthropus)
#### Post date: [March 29, 2023, 10:20pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/15 "2023-03-29T22:20:31Z")
> [@jjakucyk](#):
>
> I tend to agree, and I wonder if it’s even really a plastic
Hmmm… Cellulose based plastics are degradable; OTOH the name “polistirex” strikes me as suspiciously similar to “polystyrene”.
---
### Author:  [@Spectre\_of\_Pithecanthropus](https://boards.straightdope.com/u/Spectre_of_Pithecanthropus)
#### Post date: [March 29, 2023, 11:51pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/16 "2023-03-29T23:51:44Z")
> [@Awb78](#):
>
> Advertising.
>
> Plus the Name Brands did the legwork on research before the generics were available.
This is a somewhat different topic. While generic drugs are significantly cheaper than their branded counterparts, generic DXM cough medicine is still far more expensive than generic antihistamines, the only exception I’ve personally experienced being those California dollar store bottles I mentioned.
---
### Author:  [@dougrb](https://boards.straightdope.com/u/dougrb)
#### Post date: [March 30, 2023, 1:52am UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/17 "2023-03-30T01:52:33Z")
> [@bump](#):
>
> That’s a balancing act between selling a lot at a lower price per unit and selling fewer at a higher price.
[ ](https://cdn.corporatefinanceinstitute.com/assets/demand-curve7-1024x683.jpeg)
---
### Author:  [@Awb78](https://boards.straightdope.com/u/Awb78)
#### Post date: [March 30, 2023, 8:57am UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/18 "2023-03-30T08:57:05Z")
I totally got caught up in the threadjacking about other name brand drugs vs. generics…duh!!
---
### Author:  [@Cheesesteak](https://boards.straightdope.com/u/Cheesesteak)
#### Post date: [March 30, 2023, 12:59pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/19 "2023-03-30T12:59:45Z")
> [@bump](#):
>
> The _cost_ of the product doesn’t have anything at all to do with the price.
Not true. If you look at @dougrb 's photo of the supply/demand curve, we see that the price will eventually settle in at the equilibrium point (or near enough).
That equilibrium point is based on market forces, which include the fact that customers are willing to pay X but will always prefer to pay X-something. When something is cheap to produce, suppliers will compete to capture market share by lowering the price, so the price will settle at a lower point than for a product that is expensive to produce.
DXM is 10x the price of Benadryl almost certainly because DXM is more costly to produce and get to the customer.
---
### Author:  [@Jasmine](https://boards.straightdope.com/u/Jasmine)
#### Post date: [March 30, 2023, 1:11pm UTC](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759/20 "2023-03-30T13:11:39Z")
> [@excavating\_for\_a\_mind](#):
>
> The product XXX costs $ZZ.ZZ because that is what people are willing to pay for it. Another way of looking at it is because $ZZ.ZZ is the lowest amount that those who have XXX are willing to accept. It really is that simple.
I’d say that’s pretty accurate because the sicker you are and the more critical the medicine, the higher the cost because people will pay anything to stay alive. … if they have it. Tragically, a significant number of people simply don’t have it, but they are considered “acceptable loses” because enough do have it to make it a very profitable enterprise for the pharmaceuticals.
[Next page](https://boards.straightdope.com/t/why-is-cough-medicine-so-expensive-compared-to-other-otc-drugs/981759.md?page=2)