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If you are considering purchasing medication from outside the U.S., be aware that, in most circumstances, it is technically not legal for individuals to import prescription drugs; however, U.S. government officials have stated that individuals who order non-controlled prescription drugs from Canada or other foreign sources (up to a three-month supply) for their own use are not being pursued or prosecuted.
Are there less expensive ways of getting Nexium or esomeprazole magnesium?
If you want to stay on brand name Nexium (40 mg) or its generic equivalent (esomeprazole magnesium), there are many lower-cost options to paying full price -- which is currently an outrageous $9.50 per pill for Nexium, or about $8 per pill for the generic. You can actually get brand name Nexium from a licensed pharmacy for as little as 25 cents per pill as discussed below.
Since Nexium is a delayed-release drug, which means it is specially formulated to release the drug slowly during the day, you may want to stick to the brand name Nexium (prescription or OTC) because generic versions of delayed-release drugs may employ different delayed release formulations, resulting in a somewhat different timing of drug release.
Options at U.S. pharmacies
In the U.S., your lowest cost option appears to be the OTC version of Nexium, or still less, the generic OTC version.
The over-the-counter (OTC) version of Nexium, sold as 20mg "24HR" capsules. Each provides 20 mg of esomeprazole — exactly half the dose of the 40 mg prescription version. Don't worry that the label says "22.3 mg of esomeprazole magnesium, as this is the more complete chemical name and includes the weight of the magnesium portion of the compound — just like in prescription Nexium). Both OTC and prescription Nexium are delayed-release. The cost per 20 mg OTC pill at CVS is currently about $1. Taking two of these would be the same as taking one 40 mg pill, so your daily cost will be around $2.
There are also generic OTC versions (such as the GoodSense brand), which can cost about 36 cents per 20 mg pill, so your cost for 2 pills per day will be around 70 cents. These are also delayed-release.
If you prefer not to take two 20 mg OTC pills per day and to stick with a single 40 mg prescription version, many U.S. pharmacies accept coupons For Nexium which can bring the cost down to around $2 or less per 40 mg pill. You can find coupons at GoodRX.com. In addition, Nexium's maker, AstraZeneca also offers a savings card which will refund (after 6 to 8 weeks) up to $125 of your out-of-pocket costs for each 30-day supply you purchase from a pharmacy. So, for example, if you have to pay the full cash price of $9.50 per pill, this would appear to bring the cost down to around $5 per pill.
Options at pharmacies outside the U.S.
Finally, the least expensive option is to purchase the prescription medicine from a licensed pharmacy in a country where drug prices are much lower than in the U.S. You can do this through online international pharmacies and it's advisable to use one which has its credentials continually verified by an independent third-party, such as PharmacyChecker.com -- which also posts drug prices from these pharmacies. As of March 22, 2017, the lowest prices for Nexium 40 mg and generic versions as listed on PharmacyChecker.com were:
- Nexium 40 mg: $2.54 — 2.70 (from Canada, UK, Australia or New Zealand); $0.87 (from Singapore); $0.24 (from Turkey)
- Generic (esomeprazole magnesium) 40 mg: $0.99 (from Canada, New Zealand, or UK); $0.19 (from India)
If you order the 40 mg version of Nexium or a generic version, be aware that you will need to provide a prescription. Also, if you purchase online, you can't purchase more than a 90-day supply at one time. In addition, be aware that, technically, it is not legal for Americans to personally import their medication, but millions of Americans so it every year and the U.S. government has not prosecuted individuals for doing this.