This is what the pharmacy pays, not what you are charged. NADAC is the federal survey of retail acquisition cost, which makes it the cleanest floor available. Across 385 brands CMS prices both ways, the median costs 6.7 times its own generic.
48 of 385 exceed 100x. NORVASC costs $8.69 per unit against $0.0109 for its generic: a factor of 798. And on 18 of them the brand is the cheaper one.
Bars are on a square-root scale. On a linear one, NORVASC would flatten every other row into the axis, which is a real feature of the data and a useless picture of it.
The generic
$0.7165 median
Per unit, acquisition cost. Multiple manufacturers, no marketing to recover, no patent to amortise. This is close to what it costs to make and distribute a small molecule at scale.
The brand
$10.08 median
The same molecule under its original name. The gap is not manufacturing. It is what the market will still bear for a name after the exclusivity that justified the price has expired.
Every brand here has a generic equivalent priced alongside it, which is what CMS's correspondence means. NORVASC still carries a 798x acquisition cost against a molecule anyone can make. The gap is not a patent premium; it is a brand premium after exclusivity.
| Brand / generic | Category | Brand unit | Generic unit | Multiple |
|---|---|---|---|---|
| NORVASC Amlodipine |
Blood Pressure | $8.69 | $0.0109 | 798x |
| ZESTRIL Lisinopril |
Blood Pressure | $12.52 | $0.0188 | 665x |
| VIAGRA Sildenafil |
Erectile Dysfunction | $83.65 | $0.1298 | 645x |
| TENORMIN | EA basis | $12.80 | $0.0247 | 519x |
| LIPITOR Atorvastatin |
Cholesterol | $19.07 | $0.0382 | 499x |
| PROZAC Fluoxetine |
Mental Health | $13.98 | $0.0301 | 464x |
| INDERAL LA | EA basis | $77.62 | $0.1977 | 393x |
| ZOLOFT Sertraline |
Mental Health | $14.93 | $0.0388 | 385x |
| ARIMIDEX | EA basis | $52.60 | $0.1382 | 381x |
| LEXAPRO Escitalopram |
Mental Health | $15.43 | $0.0421 | 366x |
| CIALIS Tadalafil |
Erectile Dysfunction | $53.69 | $0.1664 | 323x |
| AMBIEN | EA basis | $22.58 | $0.0726 | 311x |
| AMBIEN | EA basis | $22.57 | $0.0726 | 311x |
| XANAX Alprazolam |
Anxiety | $7.04 | $0.0246 | 286x |
| CELEXA Citalopram |
Mental Health | $9.25 | $0.0356 | 260x |
| ZOCOR Simvastatin |
Cholesterol | $9.73 | $0.0426 | 229x |
| TOPAMAX | EA basis | $13.11 | $0.0590 | 222x |
| EFFEXOR | EA basis | $19.85 | $0.0913 | 217x |
| NEURONTIN Gabapentin |
Nerve Pain | $8.87 | $0.0410 | 216x |
| ZYPREXA | EA basis | $22.77 | $0.1086 | 210x |
| SINGULAIR Montelukast |
Allergy | $9.24 | $0.0443 | 208x |
| PROVIGIL | EA basis | $66.66 | $0.3228 | 207x |
| CRESTOR Rosuvastatin |
Cholesterol | $8.82 | $0.0427 | 206x |
| BARACLUDE | EA basis | $44.19 | $0.2207 | 200x |
| SEROQUEL | EA basis | $17.25 | $0.0882 | 196x |
| ZETIA | EA basis | $13.96 | $0.0725 | 193x |
| FEMARA | EA basis | $27.12 | $0.1455 | 186x |
| LYRICA | EA basis | $9.70 | $0.0529 | 183x |
| PERCOCET | EA basis | $31.61 | $0.1773 | 178x |
| SOMA | EA basis | $11.30 | $0.0660 | 171x |
| PLAVIX Clopidogrel |
Heart | $8.22 | $0.0481 | 171x |
| IMITREX | EA basis | $72.38 | $0.4390 | 165x |
| RISPERDAL | EA basis | $7.82 | $0.0494 | 158x |
| BENICAR | EA basis | $11.26 | $0.0744 | 151x |
| FOSAMAX | EA basis | $38.70 | $0.2571 | 151x |
| ABILIFY | EA basis | $18.67 | $0.1252 | 149x |
| LATUDA | EA basis | $46.72 | $0.3140 | 149x |
| SEROQUEL | EA basis | $11.99 | $0.0882 | 136x |
| COZAAR Losartan |
Blood Pressure | $4.51 | $0.0337 | 134x |
| CELEBREX | EA basis | $9.55 | $0.0731 | 131x |
| TRUVADA | EA basis | $59.74 | $0.4572 | 131x |
| VIREAD | EA basis | $40.73 | $0.3187 | 128x |
| ONFI | EA basis | $44.90 | $0.3568 | 126x |
| LOPRESSOR | EA basis | $2.42 | $0.0194 | 125x |
| KLONOPIN Clonazepam |
Anxiety | $3.06 | $0.0250 | 123x |
| LOTREL | EA basis | $12.21 | $0.1058 | 115x |
| PAXIL | EA basis | $10.81 | $0.1037 | 104x |
| PAXIL | EA basis | $10.69 | $0.1037 | 103x |
| GEODON | EA basis | $31.11 | $0.3167 | 98x |
| BRIVIACT | EA basis | $24.08 | $0.2491 | 97x |
| VIMPAT | EA basis | $18.87 | $0.2008 | 94x |
| MAXALT | EA basis | $44.48 | $0.4734 | 94x |
| CYMBALTA Duloxetine |
Mental Health | $8.97 | $0.0971 | 92x |
| WELLBUTRIN Bupropion |
Mental Health | $7.51 | $0.0831 | 90x |
| PROPECIA | EA basis | $3.78 | $0.0419 | 90x |
| HYZAAR | EA basis | $6.82 | $0.0761 | 90x |
| KEPPRA | EA basis | $11.53 | $0.1361 | 85x |
| DIOVAN HCT | EA basis | $11.42 | $0.1359 | 84x |
| MAXALT MLT | EA basis | $44.31 | $0.5293 | 84x |
| REMERON | EA basis | $6.58 | $0.0791 | 83x |
Sorted by gap, the inverted cases sit below the 60 shown here, and they are a different kind of row rather than a smaller number: on 18 brands the brand costs LESS than its own generic, led by KLOR-CON at 0.9x.
The obvious hypothesis is that more manufacturers drive the price down. Across all 3,439 products in the NADAC set, the correlation between the number of listed NDCs and the median unit price is -0.13 on a log scale. That is the right direction and it is weak. It describes a tendency across thousands of products and predicts nothing about any single drug on your list.
The median brand here costs pharmacies 6.7 times its own generic, and 48 of 385 exceed a hundredfold. These are the same molecules, years past patent, made by anyone who wants to make them.
And 18 of them run the other way, which is why the instruction is to look rather than to generalise.
Data: CMS NADAC (National Average Drug Acquisition Cost), published by Centers for Medicare & Medicaid Services, dataset generated 2026-07-22. 3,439 products in the full set. Look up any of them in our drug price tools.