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Why are Herpes Drugs So Expensive?

high drug prices

June 28, 2021

In the United States, genital herpes is one of the most common sexually transmitted diseases (STDs, also called sexually transmitted infections, or STIs). According to the Centers for Disease Control and Prevention (CDC), about one in six people between the ages of 14 and 49 have genital herpes.

This isn’t a problem unique to Americans, though. Herpes is incredibly common worldwide. In fact, the World Health Organization (WHO) estimates that about 491 million people across the globe have genital herpes.

Given its prevalence, one might think there are plenty of affordable herpes medications on the market. Especially considering how long ago the pharmaceutical industry started developing these drugs.

Development of prescription drugs and topical treatments for the herpes simplex virus began decades ago. By the late 1970s, "public health" and "awareness" marketing campaigns were launched.

In theory, these campaigns should have simply alerted people to the realities of the virus and what kind of treatments were available. In reality what happened was that the campaigns helped to stigmatize the virus, and ultimately created a market to overcharge consumers for expensive herpes drugs in the United States.

Despite the stigma that still surrounds the herpes virus even all these decades later, the majority of the population has actually been exposed to it at some point.

According to Johns Hopkins and the U.S. National Institutes of Health (NIH), anywhere from 50%-90% of American adults are exposed to oral herpes by age 50, which makes cold sore outbreaks (also known as fever blisters) incredibly common.

Here’s what you need to know about the herpes simplex virus and the (expensive) drugs that treat it.

What is Herpes?

Herpes is a very contagious viral infection transmitted through bodily fluids such as saliva and genital secretions. Herpes can be treated with over the counter (OTC) medication and prescription drugs, but the virus stays dormant in the body's nerve cells and can flare up from time to time throughout a person's lifetime.

The cause of herpes flare-ups can be linked to many different things, including stress, fatigue, illness, menstruation, compromised immune system, and exposure to sunlight. There is no cure for herpes at this time.

There is more than one strain of the herpes simplex virus (HSV) — HSV1, which is oral herpes (cold sores, or fever blisters), and HSV2, which is genital herpes.

While HSV2 is considered relatively common, HSV1 is even more so, with an estimated prevalence in the U.S. of about 48%. The prevalence of HSV2 in the U.S. is considered to be about 12%.

Given that HSV1 is transmitted through saliva, the difference in prevalence makes sense. HSV1 can be spread through kissing, sharing food or drinks, or touching an open sore and then touching someone else, etc. Theoretically, HSV1 can affect any part of the body, but they’re most likely to occur near a mucus membrane, which is why they’re often seen on mouths and noses.

Herpes infections of the eye are also possible and can be extremely dangerous. These are sometimes called ocular herpes or herpetic eye disease. The largest concern is that if these infections of the eye are left untreated, vision loss can occur.

Complicating matters (and frustrating anyone infected with the virus) is the fact that herpes (both HSV1 and HSV2) can also be spread to others even when the carrier isn't exhibiting any symptoms.

The herpes simplex virus is not fatal, however more caution needs to be taken leading up to childbirth. Herpes infections can be fatal for newborn babies because they literally do not have the immune system necessary to fight off the virus.

Obstetricians and gynecologists (OB/GYNs) vary in their approaches to this issue, and while it’s rare to transmit the virus during childbirth, many OB/GYNs won’t take the chance at infecting the newborn. Most OB/GYNs will prescribe one of the medications listed below in the weeks leading up to the delivery in order to prevent a flare-up, or they’ll recommend a cesarean.


How Much Do Herpes Drugs Cost in the United States?

Whether it's medication to treat a herpes flare-up, statins to manage high cholesterol (and therefore, the risk of developing heart disease), or asthma inhalers, it seems that Americans are struggling to afford their medications.

Perhaps the one guarantee in the American healthcare system is that American consumers will be expected to pay much more than Canadians and just about everyone else in the world for the exact same medications.

Even with health insurance and prescription drug coverage, the inflated price of prescription drugs is baked into the entire system. From the manufacturer to the healthcare providers, to the pharmacy benefit managers (PBMs) and the pharmacies themselves, to the government that refuses to do something about it, the reasons behind the exorbitant prices are numerous and complex. And all of these factors help drive up costs for everyone.

Here's an example of the average retail price for a few of the most common brand name prescription drugs for herpes:


Valtrex (valacyclovir) is one of the most commonly prescribed medications for people who experience herpes flare-ups. Valacyclovir is an antiviral and is taken orally on a daily basis.

This medication is designed to slow the progression of herpes simplex virus by hindering the activity of a specific viral enzyme called deoxyribonucleic acid (DNA) polymerase. This enzyme is instrumental in the replication process for HSV. Therefore, by suppressing this enzyme, the body should have fewer flare-ups.

Because the HSV virus is within the same family as shingles, Valtrex may also prevent occurrences of shingles (assuming you didn’t have the chickenpox vaccine). And of course, it may also suppress cold sore flare-ups.

In the United States, the cash price for a 30-day supply of brand name Valtrex (500 mg) is about $450.00 ($15.00 per pill). The higher dose (1000 mg, or 1 gram) is even more expensive, usually starting at $730.00 for a 30-day supply (about $24.00 per pill).

Sometimes, consumers can save money by purchasing larger quantities, but the discounts aren’t really anything to write home about. It’s usually single-digit percentages — perhaps 5% or 8%.

At, you can buy Valtrex for a fraction of the cost — about one-third, actually.

The 500 mg dose of Valtrex starts at about $220.00 for a 42-day supply (about $5.24 per pill). The per pill price remains about the same even if you purchase a larger quantity.

The 1000 mg (1 g) dose of Valtrex starts at about $226.00 for a 21-day supply (about $10.76 per pill). Unlike the smaller dose, the 1000 mg dose is about $405.00 for a 42-day supply, which comes out to about $9.64 per pill.


Zovirax (acyclovir) is another popular antiviral medication that can suppress herpes flare-ups. The way acyclovir works is unique because it converts into its active form by the virus itself.

When the virus begins to multiply, it will seek out the DNA enzyme. However, what it will find is acyclovir, which will in turn, keep it from multiplying and reduce the viral load.

Zovirax comes in a few different forms, but most of the time, oral pills are used to treat genital herpes because they reduce the chances of a flare-up. It’s preventative versus reactive.

In the U.S., the oral pills are nearly non-existent now that there’s a generic version. Insurance companies, pharmacies, and consumers all prefer the generic of most drugs, since they’re usually much cheaper.

While generic drugs generally work the same way as their brand-name equivalents, they don’t necessarily work as well for each individual person. Generic drugs might use different fillers or other inactive ingredients that the patient could be allergic to, that their body could have an adverse reaction to or that may not suit them in some way.

The generic isn’t particularly expensive in the U.S. A 30-day supply of acyclovir starts at about $10.00 ($0.33 per pill). However, at, you can buy generic acyclovir starting at $21.00 for a 100-day supply ($0.21).

If you do need the brand name formulation from Zovirax, we still have it in stock. Prices start at $58.00 for a 100-day supply ($0.58 per pill).


Denavir (penciclovir) is a topical antiviral treatment for HSV1 symptoms. It is approved for use on cold sores that occur on people’s faces. What penciclovir does is insert itself into DNA creation, which allows it to interrupt the multiplication process.

Topical herpes medications are made in both cream- and ointment-form. They’re used to treat an outbreak (and symptoms related to it) once it has already begun.

Though similar in terms of dosage and active ingredients, some people prefer one or the other since ointments tend to be oilier and messier to apply, whereas creams tend to blend into the skin once applied but may be irritating depending on the location and severity of the outbreak.

The sooner the medication is applied, the shorter the outbreak period will be, so it’s best to apply it at the first sign of a cold sore forming (usually a red mark on the skin and/or itching).

Any fiscally conscious person would balk at the thought of paying thousands or even hundreds of dollars for a few ounces of a topical cream or ointment. Even when purchasing over-the-counter treatments, it’s costly, usually running about $20.00-$25.00 for less than one ounce of medication.

While genital herpes is more easily hidden, oral herpes outbreaks aren’t necessarily as easy to conceal. Because of the shame associated with oral herpes, people often feel embarrassed, which means they might be willing to pay just about anything if it means getting rid of it sooner.

If the cost of Valtrex in the United States compared to Canada seems excessive, the cost of Denavir, a topical ointment, will seem especially outrageous.

In the case of Denavir, the average retail price for a single tube ranges between $973-$1,100 in the U.S. depending on the pharmacy where the prescription is filled (one of the many arbitrary variables that affects how much American consumers end up paying for their medications). Americans who source their prescriptions through a Canadian pharmacy website or an international one can expect to pay significantly less.

At, Denavir ranges in price from $37.00 for a 2-gram tube of cream to $200.00 for a 12-gram tube.

Factors that Affect Herpes Prescription Drug Prices

First and foremost, high prescription drug prices start with the pharmaceutical companies. They’re the ones that determine what the retail price will be set at, in addition to what amount they’re willing to negotiate down to with pharmacies, governments, and hospitals.

Second, and perhaps most importantly, the U.S. government impacts the price consumers pay for prescription drugs like herpes medications. Whereas most countries limit the maximum price pharmaceutical companies are allowed to charge to consumers, the United States does not.

The U.S. government has implicitly chosen to allow the laws of economics to dictate healthcare prices (more on that later). While there are certainly merits to that decision, one could argue that it hasn’t made healthcare affordable or accessible to most Americans.

Americans have been spending more and more on healthcare with each passing year. A study from 2019 found that people spent twice as much on healthcare in 2018 than they did in 1984 — a trend that doesn’t seem to be going anywhere but up anytime soon. It’s estimated that expenditures will continue to increase by about 5.4% each year through 2028.

Prescription drugs are just one piece of this puzzle, but it is a significant issue. As health insurance companies continue to shift the cost of healthcare onto their enrollees, one of the ways they do that is by lowering coverage. Ultimately, this means higher costs for consumers, in both premiums, copays and coinsurance, and of course, prescription drugs.

The depressing reality for many Americans is that — even with health insurance and some form of prescription drug coverage — the out-of-pocket cost of prescription medications is often more expensive than what the drugs cost in Canadian or other international pharmacies. This is often true for those enrolled in high deductible health plans (HDHPs).

It's not unusual for Americans to pay anywhere from $50.00 to $100.00 for a single prescription drug, even when they have insurance. When people are enrolled in HDHPs, they have to pay the entire cost of a prescription, with no copay. In many cases, the negotiated rate they’re paying is still more than what international online pharmacies would charge.

According to the pharmaceutical companies themselves, the cost of prescription drugs like Valtrex, Zovirax, Denavir and others depends on a number of different factors and variables. These factors include the cost of research and development, manufacturing, marketing and advertising, and even packaging. (The research and development excuse is widely overblown.)

But none of those factors convincingly explain how a prescription drug that costs about $35.00 in Canada or elsewhere can cost hundreds of dollars in the United States.

While the healthcare system and prescription drug market are incredibly complex, the main driving force behind how expensive herpes and all prescription drugs have become is actually remarkably simple: they can just get away with charging Americans more.

The American healthcare system, prescription drug market, and patent system offers pharmaceutical companies an opportunity that they don't enjoy anywhere else in the world, even in other countries with similar market-driven economies: a complete lack of regulation on pricing, and the freedom to literally charge whatever they see fit, regardless of the circumstances and impact on public health and safety.

The Psychological Component

It’s also impossible to overlook the possibility that drug manufacturers are taking advantage of the stigma associated with herpes. If one in six Americans have herpes, the problem is relatively common. And yet, despite how common it is, there’s still a great deal of stigma attached to the herpes virus, which belongs to the same family of viruses that cause chickenpox (and therefore, shingles).

People will spend any amount of money to reduce the occurrence of herpes flare-ups if they feel ashamed to have the virus. And truly, any shame they feel is pushed upon them by society, and then reinforced by the fact that people are too embarrassed to talk about it.

The stigma is a man-made problem that can be solved with actual advocacy and awareness.


Pharmaceutical Company Monopolies Make Prescription Drugs More Expensive for Americans

The love of a free market might be as American as apple pie, but the reality is actually quite different when applied to healthcare. The prescription drug market, like many others, is increasingly controlled and restricted by an exceedingly small, powerful, and influential handful of large pharmaceutical and corporate pharmacy chains (commonly referred to as Big Pharma).

While the importance of a free market is touted as a cornerstone of capitalism, pharmaceutical companies and their powerful lobbying groups spend enormous sums of time and money to keep the market as closed as possible in order to protect their soaring profit margins.

Given that so many people are likely to deal with a herpes outbreak at least once in their lifetime, wouldn't it make sense for herpes drugs to be more affordable? That all depends on your perspective.

If an expensive brand name prescription drug manufactured by a single company is the only option available, American consumers have no room to negotiate. Insurance companies and pharmacy benefit managers in the United States negotiate prices with the pharmaceutical companies, but consumers are left out of that process and are at the mercy of their insurance companies and prescription drug coverage plans.

Important Reminders About Herpes Medications

It’s important to remember that none of these medications will cure herpes, nor eliminate the possibility of transmission. Because it’s possible to transmit the virus at any time (even when there is no active flare-up), there is never a guarantee that someone won’t pass it to another person.

However, the chances of transmission are higher during a flare-up, when the sores are open. Therefore, by reducing the chances of a flare-up, the chances of transmission are also reduced.

Of course, no one wants to deal with a herpes flare-up — it can uncomfortable at best and painful at worst. Reducing the occurrences of flare-ups is absolutely a major reason most people take drugs like Valtrex and Zovirax.

However, the possibility of reducing the chances of spreading the virus is certainly a factor for many patients. They already have it and they know they cannot get rid of it — but they know they may be able to save their partner from going through it as well.

In that respect, it’s no different than covering your mouth when you sneeze — you want to save those around you from catching your cold virus. Who wouldn’t want to protect those they love?

Why Herpes Medications are Cheaper in Canada

As we've demonstrated (time and time again), Americans can save hundreds — or even thousands — of dollars by buying prescription drugs from outside of the United States, and herpes drugs are no exception.

Even with prescription insurance coverage, Americans can save a considerable amount of money every time they fill a prescription by ordering it online from a Canadian or international pharmacy from the comfort of their home.

So, what's Canada's drugs secret? Despite some myths and misconceptions (and in some cases, deliberate misinformation) about Canadian pharmacies, the Canadian government has very strong quality control and safety guidelines in place to ensure that Canadian citizens are getting the medications and prescription drugs they need at prices that are more fair and more affordable for all.

The secret to lower prices isn’t really a secret at all. Simply put, pharmaceutical companies aren’t able to inflate the prices of their prescription drugs in Canada (or most other countries) because they can't get away with it.

In the United States, the government has chosen not to regulate drug costs — which means Americans, unfortunately, have to pay whatever the pharmaceutical companies want them to pay.

In Canada — and in many other countries — the opposite is true.

The Canadian government has the power to enforce limits on how much the pharmaceutical companies can charge. For Canadians and citizens of other developed countries, more affordable prescription drugs are just common sense.

And while pharmaceutical companies may be greedy, they're not stupid: they're not about to give up access to the Canadian drugs market, so they agree to the Canadian government's rules because they have little choice – and because they are still making a fortune in Canada.

For the government’s part: they’re not stupid either. They want their residents to have access to these medications, so they’ll determine a rate that is still profitable for the pharmaceutical companies, but not so high that no one will be able to afford it.


How to Save Money with International and Canadian Online Pharmacies

If you’re having trouble paying for your herpes medication, we want you to know that you have other options. International online pharmacies like can save you money on your medications every month, and we’ll deliver them straight to your doorstep.

We may sound a bit biased, but we truly believe we’re the best online pharmacy available. We are dedicated to safety, accuracy, customer service, and low prices — and we excel at all of them.

In fact, we’ve accurately delivered millions of prescription medications. In order to do this, we are staunch in our efforts to make sure each prescription is checked and double-checked by a licensed pharmacist.

As for customer service, our customers often tell us that has their local pharmacy beat. In an era where most companies are closing their call centers and asking people to email or chat using automated bots on their websites, we’ve chosen to maintain a dedicated customer service team that you can call.

Our call center is open seven days a week and can be reached at 1-866-539-5330. They can answer any and all of your questions, check on the status of your order, and even help you place an order if you’re having trouble. Of course, you can always email us, and we’ll get back to you ASAP.

And finally, we are so certain we’ll have the lowest possible price that we guarantee it. If you can find your medication cheaper elsewhere, we’ll beat it.

If you haven’t purchased from before, we recommend looking at customer reviews on Shopper Approved and Trust Pilot. These are third-party websites dedicated to helping consumers learn more about companies before they put their trust in them.

We’re proud to say we have a 4.8/5 overall satisfaction rating with over 400,000 reviews, making us the most reviewed and highest rated online pharmacy in the world.

Getting medication that improves your physical and emotional well-being shouldn’t be out of reach. You should be able to get the prescription drugs you need affordably and safely.

When you’re ready, we’re here to help.

The information provided on the website is intended to facilitate awareness about healthcare products and medical conditions generally but it is not a substitute for professional medical attention or advice. You should always speak with a qualified healthcare practitioner before taking any prescription or non-prescription drug.
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