Ready.

What the most common prescriptions in America cost a typical household, and how it covers them.

Nessie seeded·seeded catalog

The median U.S. household

household of 3 · Richmond, VA · 306% of the federal poverty line
Income $83,730.00 a yearCoverage Average employer planBasket 10 medications, filled monthly
The question
Can a household afford the medications Americans actually take?
The average U.S. household spends $658.00 a year on drugs, over-the-counter included (BLS, 2024). This basket is ten of the most-prescribed drugs in the country, all at once.

Set the scenario

income is fixed at the U.S. median; coverage and medications are yours to change
Insurance coverage
Medications, ranked by U.S. prescriptions filled (ClinCalc DrugStats, 2024)

The twelve-month bill

Average employer plan
$1,381.20$946.80a year, after choosing how each drug is paid for and claiming assistance
Everything through the plan$1,381.20
Cheapest route for each drug6 of 10 drugs moved to a discount card−$110.40
Assistance programsRescue Inhaler Savings Card−$324.00
Twelve-month total$946.80
$78.90
$183.01 slack each month
SepOctNovDecJanFebMarAprMayJunJulAug
Steady monthly costWhat the household has spare

Household capacity

Capital One · Nessie seeded
Checking$3,900.00
Savings$540.00
Paycheck, take-home$2,801.73every 14 days · next Oct 2
Fixed obligations detected$2,726.258 merchants, monthly
Everyday spending$3,182.00
Spare each month$183.01
Safe to pay today$1,868.01

Capital City Property Mgmt $1,650.00 · Toyota Financial Services $448.00 · Verizon Wireless $168.00 — read off the household’s transactions by merchant repetition and amount stability, not typed in.

Average month for these drugs
$78.90
AFFORDABLE43% of the household’s slack
  • The household has about $183.01 a month of slack. Paid the default way, these medications cost $115.10 a month on average and $115.10 in the worst month: affordable.
  • After choosing routes and applying assistance they cost $78.90 a month on average and $78.90 in the worst month: affordable.
Show how the slack was derived
  1. Read from the household's bank account: the seeded Nessie ledger (no sandbox attached). Nothing on this page about what the household can spare is typed in; it is derived from the transactions below.
  2. For scale, gross household income is $83,730.00 a year (U.S. Census Bureau median, 2024). The ledger's payroll is take-home, after taxes.
  3. Observation window 2026-06-12 to 2026-09-19 — 99 days (3.25 months), 8 deposits and 104 outflows.
  4. Deposit source "COMMONWEALTH EMPLOYER GROUP PAYROLL": 8 deposits averaging $2,801.73, gaps 14/14/14/14/14/14/14 days -> median 14 days (biweekly), timing variance 0.0%.
  5. Payroll locked: $2,801.73 every 14 days (biweekly), confidence 100%. Last payday 2026-09-18, next 2026-10-02.
  6. Kroger Broad St: 14 charges but amount variance 18.1% >= 10% — variable spending, not a fixed bill.
  7. Amazon Marketplace: 10 charges but amount variance 18.8% >= 10% — variable spending, not a fixed bill.
  8. Chesterfield County Schools Fees: 4 charges but amount variance 21.7% >= 10% — variable spending, not a fixed bill.
  9. VCU Health Community Clinic: 4 charges but amount variance 17.3% >= 10% — variable spending, not a fixed bill.
  10. Richmond Family Dining: 12 charges but amount variance 17.0% >= 10% — variable spending, not a fixed bill.
  11. Regal Short Pump + Family Fun: 6 charges but amount variance 14.8% >= 10% — variable spending, not a fixed bill.
  12. Old Navy Chesterfield: 5 charges but amount variance 16.0% >= 10% — variable spending, not a fixed bill.
  13. Shell Hull St: 9 charges but amount variance 17.4% >= 10% — variable spending, not a fixed bill.
  14. Lowes Home Improvement: 5 charges but amount variance 16.0% >= 10% — variable spending, not a fixed bill.
  15. Bright Smiles Family Dental: 3 charges but amount variance 17.9% >= 10% — variable spending, not a fixed bill.
  16. Target Southside: 8 charges but amount variance 17.9% >= 10% — variable spending, not a fixed bill.
  17. GEICO: FIXED OBLIGATION — 3 charges averaging $152.00, amount variance 0.00%, median gap 30.5 days, due on the 22nd. Next due 2026-09-22.
  18. Comcast Xfinity: FIXED OBLIGATION — 3 charges averaging $79.99, amount variance 0.00%, median gap 30.5 days, due on the 28th. Next due 2026-09-28.
  19. Capital City Property Mgmt: FIXED OBLIGATION — 3 charges averaging $1,650.00, amount variance 0.00%, median gap 31 days, due on the 1st. Next due 2026-10-01.
  20. Verizon Wireless: FIXED OBLIGATION — 3 charges averaging $168.00, amount variance 0.00%, median gap 31 days, due on the 3rd. Next due 2026-10-03.
  21. Toyota Financial Services: FIXED OBLIGATION — 3 charges averaging $448.00, amount variance 0.00%, median gap 31 days, due on the 5th. Next due 2026-10-05.
  22. Dominion Energy: FIXED OBLIGATION — 3 charges averaging $147.27, amount variance 2.65%, median gap 31 days, due on the 10th. Next due 2026-10-10.
  23. Richmond Dept of Public Utilities: FIXED OBLIGATION — 3 charges averaging $58.00, amount variance 0.00%, median gap 31 days, due on the 14th. Next due 2026-10-14.
  24. Netflix: FIXED OBLIGATION — 3 charges averaging $22.99, amount variance 0.00%, median gap 31 days, due on the 19th. Next due 2026-10-19.
  25. Income: $6,091.26/month annualised from the detected cadence. Fixed obligations: $2,726.25/month across 8 merchants. Baseline variable spend: $3,182.00/month ($0.00 of one-off shocks excluded). Discretionary: $183.01/month.
  26. Safe-to-pay today = checking $3,900.00 minus a $150.00 overdraft buffer minus $1,881.99 of bills landing before the next payday on 2026-10-02 (Capital City Property Mgmt $1,650.00 on 2026-10-01; GEICO $152.00 on 2026-09-22; Comcast Xfinity $79.99 on 2026-09-28) = $1,868.01.

Medication by medication

plan or discount card, whichever is cheaper for the whole basket
MedicationPaidDefault wayCheapest
Atorvastatin#1tier 1
Counter $16.50 · plan rate $9.20 · discount card $7.50 a fill
The discount card beats the plan by $20.40 a year for this drug, given the rest of the basket.		Discount card$110.40$90.00
Levothyroxine#2tier 1
Counter $18.90 · plan rate $10.60 · discount card $14.00 a fill
The plan beats the discount card by $40.80 a year for this drug, given the rest of the basket.		Plan$127.20$127.20
Metformin ER#3tier 1
Counter $12.40 · plan rate $8.40 · discount card $9.80 a fill
The plan beats the discount card by $16.80 a year for this drug, given the rest of the basket.		Plan$100.80$100.80
Amlodipine#4tier 1
Counter $12.00 · plan rate $6.10 · discount card $4.90 a fill
The discount card beats the plan by $14.40 a year for this drug, given the rest of the basket.		Discount card$73.20$58.80
Lisinopril#5tier 1
Counter $11.20 · plan rate $6.40 · discount card $4.30 a fill
The discount card beats the plan by $25.20 a year for this drug, given the rest of the basket.		Discount card$76.80$51.60
Albuterol HFA (ProAir)#6tier 2Rescue Inhaler Savings Card
Counter $89.00 · plan rate $64.50 · discount card $55.00 a fill
The plan beats the discount card by $540.00 a year for this drug, given the rest of the basket.		Plan$444.00$120.00
Losartan#7tier 1
Counter $14.80 · plan rate $7.90 · discount card $6.20 a fill
The discount card beats the plan by $20.40 a year for this drug, given the rest of the basket.		Discount card$94.80$74.40
Metoprolol succinate ER#8tier 1
Counter $22.00 · plan rate $12.50 · discount card $11.00 a fill
The plan and the discount card cost the same here, so it stays on the plan.		Plan$132.00$132.00
Rosuvastatin#9tier 1
Counter $19.60 · plan rate $10.30 · discount card $8.90 a fill
The discount card beats the plan by $16.80 a year for this drug, given the rest of the basket.		Discount card$123.60$106.80
Omeprazole#10tier 1
Counter $16.40 · plan rate $8.20 · discount card $7.10 a fill
The discount card beats the plan by $13.20 a year for this drug, given the rest of the basket.		Discount card$98.40$85.20

A drug paid for with a discount card never reaches the insurer, so it does not count toward the deductible. That cost is priced in: every combination of plan and card was evaluated together, because the choice for one drug changes what the others cost. This page prices how each fill is paid for. It does not choose therapy, and it never touches a prescription.

Show every step of this calculation
  1. Priced every one of the 1,024 ways to split 10 drugs between the plan and a discount card, each with assistance applied. The cheapest split costs $946.80 a year.
  2. Every drug was also re-priced on the other route alone; none of those single changes beats the chosen split.
  3. Ties resolve toward the plan, so a drug only leaves it when leaving strictly saves money.
  4. Assistance is judged against the default-route bill, then applied to whichever routes win. A copay card only ever attaches to a drug that runs through the plan.
  5. Assumption: manufacturer assistance dollars count toward the deductible and the out-of-pocket maximum, so a card on an expensive drug can clear the deductible for everything else on the plan. Plans that run a copay accumulator do not credit those dollars; on such a plan the deductible clears later and this bill is higher.
  6. 10 medications, filled monthly for twelve months from Sep 19, 2026: Atorvastatin, Levothyroxine, Metformin ER, Amlodipine, Lisinopril, ProAir, Losartan, Metoprolol succinate ER, Rosuvastatin, Omeprazole.
  7. Average employer plan: $1,886.00 deductible, $4,000.00 out-of-pocket maximum, tier 1 $11.00 (skips the deductible), tier 2 $37.00 (skips the deductible), tier 3 $67.00, tier 4 $116.00.
  8. Every fill of every drug on the plan is adjudicated through one shared deductible and one shared out-of-pocket maximum, in the order listed. Ten independent runs would each spend the whole deductible and overstate the bill.
  9. Paid the default way (everything through the plan), the twelve-month total is $1,381.20.
  10. Atorvastatin: with a discount card, $90.00 a year.
  11. Levothyroxine: through the plan, $127.20 a year.
  12. Metformin ER: through the plan, $100.80 a year.
  13. Amlodipine: with a discount card, $58.80 a year.
  14. Lisinopril: with a discount card, $51.60 a year.
  15. Albuterol HFA (ProAir): through the plan, $444.00 a year, then $120.00 after Rescue Inhaler Savings Card.
  16. Losartan: with a discount card, $74.40 a year.
  17. Metoprolol succinate ER: through the plan, $132.00 a year.
  18. Rosuvastatin: with a discount card, $106.80 a year.
  19. Omeprazole: with a discount card, $85.20 a year.
  20. Sep: $78.90.
  21. Oct: $78.90.
  22. Nov: $78.90.
  23. Dec: $78.90.
  24. Jan: $78.90.
  25. Feb: $78.90.
  26. Mar: $78.90.
  27. Apr: $78.90.
  28. May: $78.90.
  29. Jun: $78.90.
  30. Jul: $78.90.
  31. Aug: $78.90.

How this household covers it

1 of 10 programs applied
  1. Pay each drug the cheapest way. 6 of 10 drugs move to a discount card, saving $110.40 a year.
  2. Claim what is already set aside. Rescue Inhaler Savings Card saves $324.00.
  3. Set the rest aside each payday. $946.80 is $36.42 a paycheck across 26 paychecks, each fill funded by the payday before it.
Rescue Inhaler Savings CardInhaler manufacturer (modelled) · Manufacturer copay cardsaves $324.00/yrBEST MATCH
  • Commercial or private insurance (the card is applied at the pharmacy claim). Coverage on file: commercial. Met.
  • Prescribed product is covered by this card. ProAir is on the covered-product list. Met.
  • Age 18 or older. Age 39. Met.
  • Program is accepting new enrollments. Accepting new enrollments today. Met.
Roanoke Valley Community Health Bridge GrantRoanoke Valley Community Health Fund · Foundation grantNOT ELIGIBLE
  • Resident of Virginia. Richmond, VA is in the service area. Met.
  • Household income at or below 300% of the federal poverty level. Household income $83,730.00 for 3 = 306% FPL; this program stops at 300%. Not met.
  • Grant cycle has funds remaining. Accepting new enrollments today. Met.
HealthWell Foundation — Diabetes FundHealthWell Foundation · Foundation grantNOT ELIGIBLE
  • Fund is open to new applicants. Funding exhausted for this grant cycle — closed to new applicants. Not met.
  • Household income at or below 500% of the federal poverty level. Household income $83,730.00 for 3 = 306% FPL, within the 500% limit. Met.
  • Insurance that covers the prescribed product. Coverage on file: commercial. Met.
PAN Foundation — Type 2 Diabetes FundPatient Access Network Foundation · Foundation grantNOT ELIGIBLE
  • Fund is open to new applicants. Funding exhausted for this grant cycle — closed to new applicants. Not met.
  • Household income at or below 500% of the federal poverty level. Household income $83,730.00 for 3 = 306% FPL, within the 500% limit. Met.
  • Resident of the United States. Richmond, VA is in the service area. Met.
Virginia Pharmaceutical Assistance ConnectionCommonwealth of Virginia — Dept. of Health · Foundation grantNOT ELIGIBLE
  • Resident of Virginia. Richmond, VA is in the service area. Met.
  • Household income at or below 250% of the federal poverty level. Household income $83,730.00 for 3 = 306% FPL; this program stops at 250%. Not met.
  • Grant cycle has funds remaining. Funding exhausted for this grant cycle — closed to new applicants. Not met.
Community Free-Clinic Pharmacy ProgramVirginia free and charitable clinics (modelled) · Foundation grantNOT ELIGIBLE
  • Resident of Virginia. Richmond, VA is in the service area. Met.
  • Household income at or below 200% of the federal poverty level. Household income $83,730.00 for 3 = 306% FPL; this program stops at 200%. Not met.
  • Uninsured. Requires uninsured coverage; The household has commercial coverage. Not met.
  • Prescribed product is a generic on the clinic formulary. Atorvastatin, Levothyroxine, Metformin ER, Amlodipine, Lisinopril, Losartan, Metoprolol succinate ER, Rosuvastatin, Omeprazole are on the covered-product list. Met.
Medicare Part D Extra Help (Low-Income Subsidy)Social Security Administration · Government subsidyNOT ELIGIBLE
  • Enrolled in Medicare Part D. Requires government coverage; The household has commercial coverage. Not met.
  • Household income at or below 150% of the federal poverty level. Household income $83,730.00 for 3 = 306% FPL; this program stops at 150%. Not met.
  • Age 65 or older, or qualifying disability. Age 39; the program requires at least 65. Not met.
3 programs cover none of the selected medications, each still checked criterion by criterion
NovoCare Ozempic Savings CardNovo Nordisk · Manufacturer copay cardNOT ELIGIBLE
  • Commercial or private insurance (not Medicare, Medicaid or TRICARE). Coverage on file: commercial. Met.
  • Prescribed product is covered by this card. Covers semaglutide; none of the selected medications is on that list. Not met.
  • Age 18 or older. Age 39. Met.
  • Program is accepting new enrollments. Accepting new enrollments today. Met.
  • Remaining annual benefit covers the projected plan-year cost. $6,000.00 of benefit remaining against a projected $0.00 plan-year outlay. Met.
Novo Nordisk Patient Assistance ProgramNovo Nordisk · Manufacturer patient assistanceNOT ELIGIBLE
  • Uninsured, or Medicare Part D with a documented coverage gap. Requires uninsured coverage; The household has commercial coverage. Not met.
  • Household income at or below 400% of the federal poverty level. Household income $83,730.00 for 3 = 306% FPL, within the 400% limit. Met.
  • Prescribed product is a Novo Nordisk product. Covers semaglutide, insulin-glargine; none of the selected medications is on that list. Not met.
Lilly Cares Foundation Patient Assistance ProgramEli Lilly and Company Foundation · Manufacturer patient assistanceNOT ELIGIBLE
  • Household income at or below 150% of the federal poverty level. Household income $83,730.00 for 3 = 306% FPL; this program stops at 150%. Not met.
  • Prescribed product is a Lilly product. Covers tirzepatide, dulaglutide; none of the selected medications is on that list. Not met.
  • Age 18 or older. Age 39. Met.

Manufacturer cards and patient-assistance programs do not stack on the same fill, and a copay card only attaches to a drug that runs through the plan. Foundation grants are drawn against the remaining total, each to its own cap.

The payday plan

paydays detected in the deposits · written to the account below when activated
$36.42set aside from each of 26 paychecks. Or $78.90 a fill.
FILL #1
from Sep 18
$78.90
FILL #2
from Oct 16
$78.90
FILL #3
from Nov 13
$78.90
FILL #4
from Dec 11
$78.90
FILL #5
from Jan 8
$78.90
FILL #6
from Feb 19
$78.90
FILL #7
from Mar 19
$78.90
FILL #8
from Apr 16
$78.90
FILL #9
from May 14
$78.90
FILL #10
from Jun 11
$78.90
FILL #11
from Jul 9
$78.90
FILL #12
from Aug 6
$78.90
Show how the schedule was built
  1. Twelve-month total after routing and assistance is $946.80. Split across 12 fills: $78.90 each.
  2. Payroll cadence is the one detected in the bank deposits: $2,801.73 every 14 days (biweekly), last paid Sep 18, 2026.
  3. Each installment is set aside from the last payday on or before its fill date, so the money is already in hand when the pharmacy asks for it.
  4. Spread across 26 paychecks instead, that is $36.42 a paycheck.
  5. Installment one of $78.90 is inside today's safe-to-pay ceiling of $1,868.01, so it can execute now as a transfer.

Write this plan to the household’s bank account: $946.80 over 12 fills

Installment one of $78.90 executes now as a transfer; the other 11 are written as bills pinned to the paydays detected in the deposits. Then the balance is refetched from the account. Nothing here writes, transmits or signs a prescription.

Where every number came from

sourced, or modelled — never both
SourcedModelled — realistic, not authoritative
  • Discount-card prices. Typical, not quoted; they move week to week and by pharmacy.
  • The low-deductible and high-deductible plans, and every plan’s out-of-pocket maximum. KFF publishes the distribution of maximums, not an average.
  • The household’s bank account is synthetic. Its transactions are seeded, and the badge at the top says where they were read from: Nessie seeded (no sandbox attached), Nessie replay, or Nessie live. They are built to two published constraints: take-home is the Census median income at about 87% of gross (an aggregate ratio, not a tax return), split over 26 paychecks; and spending is calibrated to about 97 cents of each disposable dollar, the complement of the BEA saving rate.
  • The spare cash is not typed in. It is derived from those transactions by the same detector that reads Maria’s account: payroll cadence from the deposits, fixed bills from merchant repetition and amount stability, everyday spending from the rest. Real households vary enormously; a median household is the only defensible single one.
  • The two added programs (rescue-inhaler card, free-clinic pharmacy) are realistic in shape and not a transcription of any live program’s rules.
  • State and household size. No state is average; Virginia is used so the state programs can be evaluated. The average household is 2.5 people and FPL needs a whole number, so it is rounded up to three.
  • Twelve months from today with the deductible untouched: the worst timing, and easy to check by hand.
  • Manufacturer-card dollars count toward the deductible. Plans that run a copay accumulator do not credit them. On such a plan a card on an expensive drug no longer clears the deductible for the rest of the basket, and the bill is higher than shown.

The household is a composite. It does not exist, and nothing here is a purchasing decision or medical advice.