Top generics by mispricing

Ranked by Mispricing Index (PMI). Higher PMI means a larger gap between US private-pay price and international generic equivalent. Each row links to the public source for both prices.

#MoleculeBrandCategoryUS priceUS sourceInternationalIntl sourcePMI
1Tenofovir/EmtricitabineTruvada (PrEP)HIV / PrEP$2000.00/monthGilead WAC 2026$10.00/monthHSA Singapore retail99.5
2Sildenafil 100mgViagraMen's health$35.00/tabletWalgreens cash$0.50/tabletIndian generic wholesale98.6
3Tadalafil 20mgCialisMen's health$40.00/tabletCVS cash$0.60/tabletIndian generic wholesale98.5
4Finasteride 1mgPropeciaHair$2.50/tabletGoodRx 2026$0.10/tabletIndian generic wholesale96.0
5Modafinil 200mgProvigilCognitive$30.00/tabletGoodRx 2026$1.20/tabletIndian generic wholesale96.0
6Atorvastatin 40mgLipitorCardiovascular$1.20/tabletNADAC 2026$0.08/tabletIndian generic wholesale93.3
7Sertraline 50mgZoloftMental health$1.50/tabletNADAC 2026$0.10/tabletIndian generic wholesale93.3
8Dutasteride 0.5mgAvodartHair$3.50/capsuleGoodRx 2026$0.30/capsuleIndian generic wholesale91.4
9Semaglutide (weekly)OzempicGLP-1 / weight$968.00/monthNovo Nordisk WAC 2026$90.00/monthHSA Singapore retail90.7
10Tretinoin 0.05% cream 20gRetin-ADermatology$80.00/tubeGoodRx 2026$8.00/tubeIndian generic wholesale90.0
11Isotretinoin 20mgAccutaneDermatology$12.00/capsuleWalgreens cash (iPLEDGE)$1.50/capsuleIndian generic wholesale87.5
12Tirzepatide (weekly)Mounjaro / ZepboundGLP-1 / weight$1069.00/monthEli Lilly WAC 2026$180.00/monthHSA Singapore retail83.2

Source notes

  • GoodRx 2026: public cash-pay coupon price from goodrx.com
  • Walgreens cash / CVS cash: list cash-pay price from chain pharmacy websites
  • NADAC: National Average Drug Acquisition Cost (CMS public data)
  • Manufacturer WAC: Wholesale Acquisition Cost (manufacturer-published list price)
  • HSA Singapore retail: licensed pharmacy retail in Singapore under Health Sciences Authority regulation
  • Indian generic wholesale: Indian generic manufacturer wholesale price + standard international retail markup