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Why are Some Retinoids so Expensive?

April 15, 2020

high drug prices

American consumers have become resigned to paying more than just about every other country for their prescriptions. From statins that manage high cholesterol to men’s health drugs like Viagra, even the most commonly prescribed drugs are relatively expensive in the United States by global standards.

Moderate to severe acne sufferers are often prescribed retinoids, compounds derived from Vitamin A to help improve skin tone and texture. They have also become very popular in cosmetic products available over the counter for the role they play in managing the signs of aging, like fine lines, wrinkles and sun damage. Retinoids are also prescribed to treat other skin conditions like melasma, psoriasis, and some types of cancer.

There are many types of retinoid products, and prices for prescription retinoids tend to vary. Some prescriptions can be significantly more expensive than others depending on where you buy them, the level of insurance coverage you have, the availability of coupons and manufacturer rebates, and the type of retinoid you’re using, among others.

Different Types of Prescription Retinoids

Retinoids cover a broad category of products, from prescription medications for severe acne and skin problems, to cosmetic anti-aging products sold over the counter or online. While retinoid products and medications are derived from Vitamin A, they have varying concentrations and chemical compositions that can have harsh side effects on the skin if they’re used incorrectly or in the wrong dosage. (It’s always a good idea to consult with a dermatologist before using a retinoid product, even those available to purchase over the counter.)

Some of the most commonly prescribed retinoid medications include:

  • Tretinoin - Renova, Retin A, Stieva, Ziana, Vesanoid, Melacare, Atralin, Refissa, Tri-Luma
  • Tazarotene - Tazorac
  • Isotretinoin - Accutane, Amnesteem, Zenatane, Claravis, Absorica, Myorisan

Retinoid prescriptions are typically for topical applications in gel, cream, or serum form. Retinoid prescriptions vary in concentration depending on factors like the severity of the acne or skin condition, as well as individual skin type and whether you’re taking other medications (people with sensitive skin types may have reactions to retinoid products, so a dermatologist may recommend a lower concentration).

With so many brands and product variations, pricing can vary considerably, especially for American consumers.

Why Do You Need a Prescription for Retinoids?

Retinoids have become a standard ingredient of many cosmetic and skincare products available over the counter, and Vitamin A occurs naturally in food and is available in supplement form, so why is a prescription necessary for some retinoid products like tretinoin and Retin-A?

Over the counter cosmetic creams and serums can be useful for anti-aging purposes like smoothing the texture of the skin and minimizing the appearance of common signs of aging like pigmentation and fine lines and wrinkles. For milder cases of acne, an over the counter retinol product with a lower concentration may be enough to treat breakouts and lower the risk of scarring, but over the counter products are less powerful than the prescription versions.

Prescription grade retinoids consist of much higher concentrations. While the higher concentration generally makes them more effective, the dosages also have to be regulated for safety and to manage the risk of side effects. In the United States, products like retinoids are marketed as a type of fountain of youth that can "turn back the clock" and help create perfect skin, but sensitive skin types may be more prone to side effects.

Retinol products trigger cell turnover on the skin to boost collagen production and rapid growth of new cells. The prescription grade retinoids available at higher concentrations may show results over the course of a few weeks, whereas a retinol based commercial product generally works more slowly and begins to show results over the course of a few months.

Retinoid products can sometimes make the skin look (or feel) worse in the beginning and cause peeling, dryness, redness, and sensitivity to the sun. If you have sensitive or delicate skin or suffer from acne, using a product that's too harsh for your skin can lead to scarring or make the problem worse.

Non-Cosmetic Uses for Retinoids

In addition to treating acne, retinoids are also prescribed as part of the treatment plan for some forms of cancer due to the role they play in signaling cell differentiation and maturity.

When used in cancer therapy, retinoids are prescribed in conjunction with other medications and chemo. The types of retinoids used in cancer therapy are also derivatives of Vitamin A but differ from the compounds used to treat acne and premature aging. Isotretinoin, a retinoid used in cancer therapy, is administered orally in pill form.

How Much Do Retinoids Cost?

Like most prescription medications in the United States, there isn’t a standard pricing model for retinoids. With the availability of several brand name and generic versions, insurance plans with varying degrees of coverage and pricing, and individual pharmacies factoring into what each consumer will pay, doing some comparison shopping is usually the best way to find the lowest prices available for a retinoid prescription.

The manufacturing process, advertising and marketing costs (in the United States) also play a role in how much the end user will ultimately end up paying for a product. With a product like retinoids, the process of manufacturing a gel or cream that can effectively preserve and deliver a working dose of the active ingredient is more complicated than making a basic Vitamin A supplement for oral ingestion.

For example, retinol products have to be transformed into retinoic acid through enzymes in order to work, so retinol based products are typically weaker and have lower concentrations than Retin-A, which is a retinoic acid that can be absorbed directly into the skin to produce results. They're both a type of retinoid, but a higher concentration retinol product is generally less powerful than a Retin-A prescription even at very low dosages.

Topical creams and gels also have a limited shelf life and window in which they can be used and produce the best results.

Retin-A prescriptions are covered by some insurance plans depending on the provider and the specific terms of the plan, so there are many variables that affect what an individual consumer will pay for a prescription in the U.S. On average, a 20-gram prescription of Retin-A (approximately 0.7 ounces) retails for about $75 (tretinoin is the generic version of Retin-A and costs roughly half at about $40).

Even with prescription drug coverage of a generic retinoid like Tretinoin, the out of pocket co-pay costs can range from a few dollars to hundreds of dollars depending on the dosage. Some plans will only cover a specific type of prescription, as in the case of certain Medicare prescription plans which may cover the generic prescription but not the Retin-A (brand name) version.

The Pharmacy Difference

For American consumers, another important factor in how much a prescription will cost is where it gets filled. It may be convenient and time efficient to fill out your prescription at the local CVS or Walgreens while you shop for groceries your household necessities, but unlike retail chains like Starbucks or Chipotle, corporate pharmacy chains don’t adhere to universal or standard pricing models. The exact same prescription and dosage can range from just a few to a hundred dollars or more from one pharmacy chain to another.

How to Save Money on Your Retinoid Prescription

Even with health insurance and prescription drug coverage, many Americans find it difficult to afford even moderately priced medications on a regular basis. Customers without any insurance are the hardest hit because the retail price for the average prescription is usually much higher than normal. If you have insurance, check with your plan provider before filling your prescription to find out what they cover, and how much you will be expected to pay out of pocket, which usually includes co-pays as well as deductibles for many plans.

Depending on the type of retinoid that your doctor prescribes, there may be a cheaper generic version available. Keep in mind that generic and brand name versions of a medication may contain different ingredients or concentrations of a specific ingredient, so you should always consult with your doctor and pharmacist on every prescription to ensure that you’re getting the right product and dosage.

Generic versions are not always available and, in some cases, may not be a good substitute for the brand name version, but they are often a good place to start when trying to save money on certain prescriptions.

Manufacturer and Pharmacy Rebates, Discounts, and Coupons

Some pharmacies and pharmaceutical companies offer discounts and rebates on some of their prescriptions. While they may not always be available or come with certain restrictions, it's generally a good practice to ask and see what's available before paying full price for a prescription (even with insurance).

Price Check Your Pharmacist

Many over the counter cosmetic products contain retinoids, but unlike a jar of face cream which may cost about the same whether you buy it at Sephora or Target, the same doesn't hold true for prescription retinoids.

Even if the price range and savings on an individual prescription isn't significant, it can add up over time, especially for prescriptions that require refills. Become familiar with what the pharmacies you use are charging so that you can make informed decisions before dropping off your prescriptions.

Are Retinoids Cheaper in Canada or Internationally?

More and more Americans are finding much needed relief from expensive prescription medications through online Canadian pharmacies and international drugstores. Depending on the prescription, the savings available through a Canadian pharmacy or international one can be significant for American consumers.

Here are some examples of typical prices for tretinoin and Retin A in Canada:

  • Retin A (cream) - 20 grams (.1%) $21.49, 20 grams (.05%) $21.49, 30 grams (.025%) $32.19
  • Retin A (gel) - 20 grams (.05%) $18.09, 20 grams (.10%) $23.89

In some cases, a generic alternative of a prescription medication that’s available in the United States may not be available to purchase from a Canadian pharmacy (such as Renova cream, in the case of retinoids).

The standards for safely shopping and buying your prescriptions from an online Canadian pharmacy are the same as with filling your prescriptions at home, but you will need to take extra precautions to ensure that you're shopping at a legitimate pharmacy and getting an authentic product.

Many prescription drugs are generally cheaper in Canada and other countries than in the United States due to government regulation and price control measures designed to keep medications affordable, but shopping at an international or online Canadian pharmacy is not a substitute for getting a prescription from a licensed doctor. If a pharmacy claims to operate legally out of Canada and offers to sell medication without a prescription, consider that a red flag.

NorthWestPharmacy.com is dedicated to helping our American customers save as much money as possible on prescriptions. Our customer service team is available to answer all of your questions about your prescriptions and how to safely place an order online. For more information about our products and ordering process, call our toll free number 1-866-539-5330 to speak to a customer service representative, or contact us online.

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