Avanafil 100mg PMI 49.8 - $80 US vs $40 internationalArmodafinil 150mg PMI 47.8 - $50 US vs $26 internationalTirzepatide 5mg (weekly) PMI 36.9 - $1,069 US vs $674 internationalSildenafil costs 97% less if you cross a border. The molecule is the same. The molecule does not care.GoodRx coupon is still a markup. A smaller one. But still.Cost Plus Drugs charges $0.14 a pill for finasteride. CVS charges $4.95. Same molecule, same factory.The US private-pay price for tirzepatide can buy 11 months of the international generic.WAC is what manufacturers tell wholesalers it costs. Cash is what you pay at the counter. They are not the same number.No insurance? Welcome to the markup index.If you can name three pharmacies that sell modafinil for under $40, congratulations, you read this site.Avanafil 100mg PMI 49.8 - $80 US vs $40 internationalArmodafinil 150mg PMI 47.8 - $50 US vs $26 internationalTirzepatide 5mg (weekly) PMI 36.9 - $1,069 US vs $674 internationalSildenafil costs 97% less if you cross a border. The molecule is the same. The molecule does not care.GoodRx coupon is still a markup. A smaller one. But still.Cost Plus Drugs charges $0.14 a pill for finasteride. CVS charges $4.95. Same molecule, same factory.The US private-pay price for tirzepatide can buy 11 months of the international generic.WAC is what manufacturers tell wholesalers it costs. Cash is what you pay at the counter. They are not the same number.No insurance? Welcome to the markup index.If you can name three pharmacies that sell modafinil for under $40, congratulations, you read this site.
OOPI June 2026
The Out-of-Pocket Index, June 2026.
Six anchor molecules. One US private-pay column. One international column. The PMI is the percentage gap between them, recomputed at the start of every month. This issue locks data as of 2026-05-25.
6
Tracked Molecules
49.8
Highest PMI
34.0
Average PMI
+4.3
Biggest Mover (pts)
v1.2
Methodology
June 2026 Index
Data lock 2026-05-25 . Private-pay prices . No insurance
Molecule
US Private Pay
International
PMI (June)
Delta vs May
Direction
Avanafil 100mgStendra
$80 / tablet
$40 / tablet
49.8
-1.5
v down
Armodafinil 150mgNuvigil
$50 / tablet
$26 / tablet
47.8
+1.8
^ up
Tirzepatide 5mg (weekly)Mounjaro
$1,069 / mo
$674 / mo
36.9
-2.5
v down
Vardenafil 20mgLevitra
$50 / tablet
$36 / tablet
28.6
+0.6
= stable
Semaglutide oral 14mgRybelsus
$968 / mo
$741 / mo
23.4
+0.3
= stable
Semaglutide 2.4mg (weekly)Wegovy
$968 / mo
$799 / mo
17.5
+4.3
^ up
Top Movers, June 2026
Semaglutide 2.4mg (weekly) (+4.3 pts, up)
Wegovy US shortage easing. Private-pay edged up while international held.
Tirzepatide 5mg (weekly) (-2.5 pts, down)
Mounjaro savings-card uptake increased, US effective cash-pay floor edged down.
Armodafinil 150mg (+1.8 pts, up)
US Nuvigil retail held flat. International generic rose 0.40 USD on INR weakness.
Related issues
June 2026, alternative views
Bitcoin Edition
The same basket, priced in sats, with monthly BTC lock and live spot drift.
This site does not sell, recommend, or dispense medication. Prices are editorial observations. Consult a licensed healthcare provider before any prescription decision.
§
Publisher's note. Rx Price Tracker is funded by PHARMAX, one of the international pharmacies whose prices we publish on this page. PHARMAX does not control which molecules we cover, which competitors we include, or which corrections we issue. Every price observation links to its source URL and capture date. The data is reproducible. We track the gap because pricing transparency works in any direction.