Oracea Too Expensive ?


Some interesting comments from KUNC commentator Dr. Marc Ringel via a NPR segment. He raises two points that are worth discussing.

Firstly is Oracea really any better than generic doxycycline and secondly what does it say about the pharmaceutical industry (and insurance companies – ed) that a repackaged old product  can be so expensive ?

Galderma would say that Oracea is sub-antimicrobial and 50mg doxycycline is a low-dose antibiotic. The distinction is that Oracea will maintain a blood serum level less than 1000 nano grams/mL (i.e. 1.0µg/mL) for the 24 hours post ingestion. 50mg of doxycycline will result in a blood serum level above the `antimicrobial threshold’ of 1.0µg/mL. This can potentially lead to side effects such as antibiotic resistance, abdominal upsets etc., although the amount by which this threshold is exceeded is still relatively small.

At best I would say that the pharmacological benefits of Oracea over 50mg generic doxycycline are are still up for debate.

Cost of Oracea

As to the cost of Oracea, Galderma of course has shareholders like every large pharmaceutical company. Marketing to both health providers and directly to consumers make sense to gain the largest market share possible. Given that they are so few treatments directly targeted at rosacea sufferers it is clear why Galderma wants patients to ask for Oracea by name and for Oracea to be strongly associated as a front line rosacea treatment.

By way of comparison, in Australia pharmaceutical companies are prohibited from marketing prescription brand names directly to the public. Advertisements usually end with a request to ask your doctor for more information. This reduces the pressure doctors feel to prescribe a particular product but may also result in less consumer choice and involvement in their treatment.

In the end, for those with good insurance cover this whole topic is pretty moot as Oracea will be affordable. Additionally those who cannot afford Oracea have a cheap viable alternative in 50 mg of generic doxycycline once a day. See your doctor for more information.

KUNC: The Big Zit Rip-off, Marc Ringel

GREELEY, CO (2009-05-18) Most agree that something needs to be done to overhaul America’s healthcare system. But leave it to KUNC commentator Dr. Marc Ringel to illustrate the problem – through something as small and innocuous as a pimple.

Or you can buy Oracea, a brand-name doxycycline marketed by Galderma Laboratories. Oracea will set you back over $200 a month if you purchase it in this country or about $150 if you shop online and make your buy from a Canadian outfit. To be sure, the dosage of Oracea is 40mg, making it, like the baby bear’s porridge, just right.

I cannot imagine, though, how the extra 10 mg in a 50 mg generic doxycycline capsule could cause close to the distress that too-hot or too-cold porridge did to Goldilocks. Nor do I see how Oracea would work better than the plain vanilla generic except, perhaps, for an enhanced placebo effect generated by spending so much money on a product marketed especially to this affliction. A person might figure that such an exorbitantly expensive brand name would just have to work better.

How Much Does Oracea Cost?

Are you ready for a shock? The full price of this 40mg of doxycycline can be scary.

Sue says via email: “Today at Walmart in LA they wanted $485 for a 30 day supply of oracea.  Guess I will take 50 mg of doxycycline.  🙁  What Galderma charges for oracea is criminal in my opinion.”

If you want to be really scared, have a look at How much do Rosacea Prescriptions Really Cost?

Oracea is Increasing in Price

Sadly for rosacea sufferers, recent research is showing that Oracea in only increasing in price – in 2015 costing an astounding $702.46 for 30 tablets.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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22 Reader Comments

  1. Thomas Barrows, MD says:

    The cost of new medications versus their actual benefits is certainly a debate worth having! I am a physician and Rosacea patient. I was spending a little over $200 a month on Oracea and I found that it worked very well. However, I switched to once a day dosing of generic Doxycycline 100 mg and find the results are the same and it now only costs me about $5 a month for therapy.

    I suspect I could probably cut back to only 50 mg of generic Doxycycline a day since there are reports of the effectiveness of this dose. I have never had any GI complaints or problems with photosensitization with generic Doxycycline and frankly I think these concerns are over-rated.

  2. When I was trying to wean myself off doryx I went down to 50mg a day and then 50mg every second day and I think this helped me taper down. I did this over a few months and was eventually able to stop them altogether.

    So for me 50mg of doxycycline a day was quite a satisfactory treatment.


  3. maureen rosky says:

    Hi Digital Davo, just reading the comments you and Dr. ThomasBarrows made in regard to Orancea. Could you or the Dr. answer a question I have in regards to treating Seborrhea Dermatitis? Can Doryx 150mg treat a person who has Rosacea plus Seborrhea Dermatitis. I did hear that Doryx is the generic form of Doxycline. A person on one of the other sites was given this for her Rosacea and Seborrhea Dermatitis and has had great results. It ‘s like her Rosacea is gone.
    Thanks ,I hope someone can comment

  4. Hi Maureen,

    150mg a day of doxycycline is a standard dose to reduce the papules and pustules of rosacea. Whilst other treatments like anti-fungals or topical steroids are often the first line treatment for seborrheic dermatitis it is possible that the anti-inflammatory and anti-biotic effects of doxycyline at that dose helps SD too.


  5. maureen rosky says:

    Hi David, Thanks for your comment. Do you know how long people can stay on Doxycycline?
    Thanks Maureen

  6. Sarah G says:

    The regular antibiotic doses definitely work but for me there are two problems: 1)antibiotic resistance 2) I get other problems like yeast infections and urinary tract infections because the “good” bacteria also get killed by the antibiotics. So I end up spending money on doctor visits and probiotics…but still cheaper than paying the $300 for Oracea. I have insurance, but the expensive dermatology treatments are often not covered. I’d be willing to pay up to $100/month (still way overpriced) for Oracea. However, they insist on charging well over $300. Right now I have a card from the manufacturer to get the meds for $25 month for the next year or so…so they get me liking it so I stay on it. I still won’t be able to afford $300. Why don’t they just charge like $75 and they would have millions more people buying their drug??? If the $25 deal goes away, I will probably try the Periostat 20mg (doxycycline) twice daily instead. Not perfect but better than the 500mg twice daily of tetracycline I have taken in the past.

  7. Ruff says:

    try 20mg twice a day… one in the morning and the other one drinking with water , crush it in there … u have your own extended released dose…

    pass the voice… save the $$$ away from the pharma industry

  8. john c says:

    I was on doxycyclin (40 mg) for five months and it worked well, though I had a slightly upset stomach from time to time. Then my doctor prescribed Oracea (40mg) over a 3 month period and it worked really well, with no side effects I could discern. But then she said she had to stop prescribing it after this time period, for 4 weeks at least. Now my skin has blown up again and my nose is swollen and pustular. I am back on metrogel and skinoren and find them almost totally ineffective. So my question is, how long term can one use Oracea for, because I for one, would be “happy” to afford it as long as I could.

    Thank you,


  9. Deborah says:

    I am 52 years old and I used Tetracycline for about a year. The stomach upsets got worse and worse so that I absolutely could not take it anymore. I had nausea, and actual stomach pain. After stopping the Tetracycline, my face became a disaster with huge painful cysts forming under the skin and lasting for weeks.

    I started Finacea, which helps to dry out the cysts, but not prevent them. These cysts were causing facial scarring and I was about at the end of my rope when I started Oracea.

    I have no stomach upsets, and the drug is very effective in preventing the cysts on my face.

    The drug company has a rebate program, where it will cover the cost of the medicine that your insurance doesn’t cover, and all you pay is a $25 copay for the medication. The program expires at the end of 2010, so you will have the $25/month copay for a year. Ask your dermatologist about it.

  10. Robin tells us over at the facebook page:

    “Oracea is now only $10 a month! My dermatologist said that the company is now in the “teen acne” market and they wanted to keep it cheap to compete with other acne meds. I got a coupon from my doc and the pharmacy only charges me $10.”

  11. Paul says:

    Have been on 50mg of doxycycline for over 5 years to treat acne, dermatitis, and rosacea. It is quite effective. I take a greek yogurt a day, and that keeps away any candida or thrush I was experiencing in the first few months. However, in the past year I have experienced upper stomach upset almost daily, even when i take the doxy with a full meal. Was thinking of trying the 40mg of Oracea, but does its delayed release really make a difference in stopping abdominal distress? I do not trust the drug companies, they are ripping so many people off with the high price of Oracea. Oracea is cost-prohibitive. What about trying 25mg of doxycycline a day? Is it just as effective on acne, and sub-microbial to boot? Any thoughts?

  12. Adana says:

    I took Doryx for 3 months, paying $25.00/month for it this past summer thanks to a card my physician assistant gave me. I then was put on Oracea 40mg at $10/month with a card my doctor gave me until last month then the co-pay went up to $25. The treatment has been remarkable and made such a difference to my life as metrogel and metrocream did nothing for me. I had actual pain and burning on my face with the redness and swelling and open pustuals, so my quality of life has improved 10 fold with this treatment and I’m not self conscious about how I look all the time. I don’t even wear make-up anymore as my skin looks that good (I’m 61 years old). I have now used up the Oracea card that allowed me to get the Oracea 3 times and today the pharmacy wanted $86 for a 30/day supply. Not sure what I’m going to do at this point….maybe talk to the physician assistant next week or see what the pharma company does once we hit January 2013 and if they offer a coupon or only take it every other day. I’m anxious to hear about the 25mg of doxycycline and what people think of that treatment.

  13. Curt says:

    How about doxy going through the roof but oracea is the same price as 2009 when this article came out. Best part is I don’t get GI upset or need to worry about photosensitivity and it works better than 100 mg. interesting enough I found out Galderma invests in research and development for new medications. I’ve yet to find an article on generics coming out with new molecules or vehicles-0 research. In fact all genetics keep doing is raising their price. Today they are priced 5-10% below brands with less efficacy and more adverse events and less safety studies.

  14. housemaid says:

    Oracea the same price it was in 2009? Hardly! Look at GoodRX for the cost in your area. In my part of the US it ranges from $520 to $583 for 30 days worth, and that is with a drugstore or the GoodRX coupon! Yes, you can get a $25 co-pay from the manufacturer if you have good insurance that covers it. Medicare Part D does not cover it, nor Medicaid nor other federal programs which I would assume means Obamacare, Tricare, VA. The price for Doryx (doxycycline hyclate) is currently $415. However, generic doxyclycline monohydrate (same as in Oracea), can be had for as little as $31 with a drugstore coupon for a month’s worth. That is, if you can find it. GoodRX says that prices may have increased Dec. 1, 2014 and it may be currently unavailable due to “shortages”. Hmmm, wonder why that is?!!!

    Did you know that they sell 100 mg powders and pills of doxycycline OTC for fish and birds? Some advertise pharmaceutical grade. Very interesting. For those taking doxy as a substitute for Oracea, why take so much at once? Quarter your 100 mg tablet and take 25 mg twice a day. Then you have a sub-antibiotic dose. You can even cut off a smidgen of the tablet to approximate 20 mg twice a day. The part that is delayed release in Oracea is only 10 mg. Do you think that part lasts for 24 hours? It seems unlikely.

  15. goofyfoot2010 says:

    I lost my dermatologist and her $20 coupons with my new insurance so I’ve been without for a few weeks. Usually my face would be breaking out already. But! I was prescribed another anti-biotic for another procedure I had just had done and when that looked like it was passed the point of infection I tried something.

    I cut the pills in half (the prescription was for two tablets a day) and took half in the morning and half in the evening. Right now my skin is as clear as it’s ever been. I have about a weeks worth of this stuff left and will update with the name (forgot the bottle at home) and the results. May youtube it. Also need to see if there are any side effects to liver etc.

    Oh and with Blue Cross this medicine was a buck.

    • Rachel Long says:

      I went to fill an Oracea ex yesterday, $700 for 90 pills. The generic was $600. Needless to say, the RC wasn’t filled. This price gouging is nothing short of criminal.

      • I wrestled my dermatologist to give me 20mg regular old doxycycline and I’d take it twice a day. She really fought me on it. Been on it about six months. world BETTER than oracea for $4 a month.

  16. Elizabeth Green says:

    I have ocular rosacea and have found that the only thing that helps reduce the pain, redness and gritty feeling sadly is Oracea. I have not heard of anyone else having this problem but any other form of doxycycline, including Periostat, gives me a terrible headache. I tried for 10 days to take Periostat and had a headache for 10 days. I was thrilled when I heard generic Oracea had been approved, only to find it costs just about $100 less than the brand. I have insurance which helps, but still have to pay $215 a month.

    • housemaid says:

      Elizabeth, try the Cliradex eyelid wipes sold on Amazon for about $43 a box. It is for ocular rosacea and kills the demodex mites. I use the wipe all over my face twice a day. I save each wipe in a snack size plastic bag to use twice. The wipes are small and you don’t get but 24 per box. However, they have stopped my ocular rosacea and the pimples/papules on my face just as well as doxy or Oracea ever did.They don’t stop the flushing, though.

  17. Paloma Valenzuela says:

    I also suffer from ocular rosacea and did try the cliradex wipes, but it stings and irritates my eyes. Then my opthalmologist introduced me to Avenova and has worked wonders. I have been using it for 9 months along with restasis and doxycycline 75mg daily and have not had any flare ups so far. My eyes and akin are clear after struggling with rosacea for years. Avenova has a $35 coupon for those whose insurance covers it.

  18. Tim M says:

    I was just prescribed a 30-day supply of Oracea from my dermatologist. I went to King Soopers to fill the order and was quoted $1700!!!! WTF!!

  19. Last year I started to use Oracea last year, and it worked well. For some reason, my insurance stopped paying for it this year. I asked for the regular price -without insurance,- and I was quoted about $490 for a 30-day supply at CVS.

    What happened?

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