Gout is cheap to treat and expensive to shop for. The two drugs at the center of it, colchicine for an acute flare and allopurinol taken daily to keep flares from starting, both cost a pharmacy pennies a tablet. What a cash payer is quoted at a counter ranges from about $6 to well over $200 for the same 30 colchicine tablets, depending entirely on the form, the label and whether any discount is applied.
Colchicine is also the most notorious price story in American pharmacy. The plant extract predates the Food and Drug Administration by centuries and was sold in the United States for decades as an unapproved marketed drug at pennies a pill. In 2009 a single manufacturer put it through FDA approval, won exclusivity, and the price rose by more than an order of magnitude. Every figure below was researched on September 3, 2026.
What Do Colchicine and Allopurinol Cost Without Insurance?
Acquisition costs come from the CMS National Average Drug Acquisition Cost survey, with generic rows effective August 19 and August 26, 2026, the Mitigare row effective August 19, 2026, the Lodoco row effective December 29, 2025 and the brand Colcrys row effective February 19, 2025 (CMS has published no fresher Colcrys vintage). Cash prices come from Cost Plus Drugs, Drugs.com, SingleCare and Agepha Pharma, all read September 3, 2026.
| Option (30-day supply) | Low | Average | High |
|---|---|---|---|
| Generic colchicine 0.6 mg tablets | $3.55 (CMS acquisition cost) | $6.52 (Cost Plus Drugs) | $25.33 (Drugs.com) |
| Colchicine tablets with a free discount card | $12.20 | $12.20 | $12.20 |
| Colchicine tablets at unhelped retail | $176.10 | $201.49 | $226.87 |
| Generic colchicine 0.6 mg capsules | $56.29 (CMS acquisition cost) | $68.82 (Drugs.com) | $68.82 |
| Brand Mitigare 0.6 mg capsules | $180.29 (CMS acquisition cost) | $180.29 | $180.29 |
| Brand Colcrys 0.6 mg tablets | $207.26 (CMS, Feb 2025 vintage) | $207.26 | $207.26 |
| Lodoco 0.5 mg (cardiovascular indication) | $99.00 (manufacturer cash route) | $305.00 | $509.98 (CMS acquisition cost) |
| Generic allopurinol 100 mg | $0.95 (CMS acquisition cost) | $5.70 (Drugs.com, 20 ct) | $6.42 (Drugs.com, 30 ct) |
| Generic allopurinol 300 mg | $1.64 (CMS acquisition cost) | $5.18 (Drugs.com, 90 ct rate) | $8.41 (Drugs.com, 30 ct) |
| Generic febuxostat 40 to 80 mg | $6.34 (CMS acquisition cost) | $7.39 | $8.43 (CMS acquisition cost) |
The two retail figures disagree and the gap is worth publishing rather than smoothing over. Cost Plus Drugs shows a $176.10 retail comparison for 30 colchicine tablets while SingleCare states a $226.87 average retail price for the same quantity, so the honest cross-source range for walking in with nothing is roughly $176 to $227. Anyone using a card, a coupon or a mail pharmacy lands between $6 and $25 instead. Per-pharmacy quotes on discount-card sites move between sessions, so treat any single chain’s number as an illustration of the spread.
Allopurinol is the cheapest drug on this page and one of the cheapest on this site. At 5.5 cents a tablet in federal data, a 30-day supply of the 300 mg strength is $1.64 of actual medicine. Everything above that is dispensing.
Why Colchicine Costs What It Costs
Drugs@FDA records the original approval of Colcrys, NDA 022352, on July 29, 2009, with the submission classification “Type 7 - Drug Already Marketed without Approved NDA” and a priority, orphan review. That single line explains the whole price history. Colchicine had been sold for decades without an approved application, FDA’s Unapproved Drugs Initiative invited a sponsor to run a trial and file, and the approved product got exclusivity while the unapproved versions were ordered off the market.
The price consequence is documented. A JAMA Internal Medicine analysis of national Medicaid and Medicare data, published November 2020, found that inflation-adjusted and rebate-adjusted Medicaid unit prices rose from $0.24 per pill in 2008, when only unapproved formulations were sold, to $4.20 per pill in 2011 when Colcrys was the only product, and peaked at $4.66 per pill in 2015. The same analysis puts 2017 Medicare and Medicaid spending on single-ingredient colchicine above $340 million and notes that Colcrys entered the market in 2009 at about $5.00 a pill.
Sixteen years later the generic tablet is back down to 11.8 cents in federal acquisition data, which is still roughly half again what the unapproved product cost in 2008 before inflation. Brand Colcrys is now listed as Discontinued in Drugs@FDA, with a Federal Register determination that it was not withdrawn for safety or effectiveness reasons. Third-party price guides still publish Colcrys prices, so if you are quoted one, ask whether the pharmacy can actually source it.
What Drives the Price
Tablet or capsule. This is the largest avoidable swing on the page. CMS prices a generic colchicine 0.6 mg tablet at $0.11823 and a generic colchicine 0.6 mg capsule at $1.87622, about sixteen times more for the same strength on the same day. Drugs.com shows the same pattern at retail: $68.82 for 30 capsules against $15.81 to $25.33 for 30 tablets. The capsule exists because Mitigare, the brand, is a capsule.
Brand or generic. Brand Mitigare is $6.00967 a capsule in the August 2026 acquisition data, more than three times the generic capsule and more than fifty times the generic tablet. Brand Colcrys sits at $6.90850 a tablet in its last published vintage.
Which indication the label carries. Lodoco is colchicine 0.5 mg, approved for cardiovascular risk reduction rather than gout, and it is priced like a cardiovascular drug: $16.99949 a tablet in federal data, about $510 for 30 days. Agepha Pharma undercuts its own list price for cash payers, stating on its patient page that uninsured patients can pay as little as $99 a month through BlinkRx or Marley Drug with free home delivery. Gloperba, the branded oral solution, returns no row at all in the federal acquisition dataset, so there is no public benchmark for it.
Whether you use any discount at all. The difference between an unhelped counter price and a card, coupon or mail pharmacy is roughly $165 to $215 a month on colchicine. That is a bigger swing than any clinical choice on this page.
Strength, oddly. Allopurinol is a warning about assuming that a cheap generic is cheap at every strength. Drugs.com lists 90 of the 100 mg tablets at $5.96 to $10.77 and 90 of the 300 mg at $15.55, but 90 of the 200 mg tablets at $357.10 to $508.89. If your prescription is written for an unusual strength, price it before you fill it.
Cash Price vs. Insurance
Both of these drugs are clean cases for skipping the pharmacy benefit. If your copay is $10 or $15, a $6.52 mail order for colchicine or a $5.18 monthly rate on allopurinol beats it outright, and there is nothing to prior-authorize.
The usual tradeoff applies. Money spent outside a plan does not count toward a deductible or an out-of-pocket maximum, and a discount card cannot be stacked with insurance on the same fill. On drugs this cheap that lost deductible credit is not worth chasing.
Where insurance status genuinely changes the answer is Lodoco. Agepha’s page advertises as little as $30 for a 90-day supply for eligible commercially insured patients and as little as $99 a month for uninsured patients through its named mail pharmacies. Those are two different programs with two different prices, and the uninsured route is the one to ask about if you have no coverage.
If a pharmacy quotes you three figures for generic colchicine tablets, run it through our fair price checker before paying. A $200 quote on this drug reflects a pharmacy contract, not the market. If a hospital or clinic has already billed you at a markup for a gout visit, our guide to negotiating medical bills covers what to say.
How to Pay Less
-
Ask whether your prescription is for tablets or capsules. Switching forms is a conversation with your prescriber, not something to do at the counter, but knowing that the capsule costs roughly sixteen times the tablet in acquisition cost is worth raising. It is the difference between $6.52 and $68.82 for 30.
-
Price a transparent mail pharmacy first. Cost Plus Drugs charges $6.52 for 30 colchicine tablets and publishes the breakdown: $1.32 of manufacturing cost, $0.20 of 15% markup and $5.00 of pharmacy labor, plus $5.25 shipping per order. Roughly 80% of that order is not medicine, which is normal for a drug this cheap.
-
Run a free discount card if you fill locally. SingleCare’s colchicine page, prices updated September 3, 2026, showed a $12.20 card price for 30 of the 0.6 mg tablets against a stated $226.87 average retail. Our comparison of GoodRx vs. SingleCare explains how to check both on the same prescription and why an online quote can move between visits.
-
Ask for a 90-day prescription on the daily drug. Colchicine for a flare is a short course, but allopurinol is taken every day, and fixed costs dominate. Drugs.com prices 30 allopurinol 300 mg tablets at $8.41 and 90 at $15.55, so tripling the quantity costs 85% more rather than three times more.
-
Do not assume a $4 generic program covers it. Walmart’s published Prescription Program list, effective March 24, 2025, contains no colchicine and no allopurinol entry in any category. Check the current list at the counter before transferring a prescription expecting a flat price.
-
Budget for the uric acid testing and the visits, not the pills. Managing gout means periodic blood work, and the lab bill usually exceeds the drug bill. Our blood work cost guide covers cash lab pricing, and a free or sliding-scale clinic can often handle the prescribing visit and refills at little or no cost.
Bottom Line
Budget $6 to $25 for 30 generic colchicine tablets and $2 to $8 a month for generic allopurinol without insurance, and treat a three-figure quote on either as a reason to shop rather than a fact about the drug. The unhelped retail range of roughly $176 to $227 for colchicine is the price of not asking.
The expensive versions are all label choices rather than chemistry: the capsule instead of the tablet, brand Mitigare instead of the generic, and Lodoco at $510 in acquisition cost when its own manufacturer will sell it to a cash payer for $99. For the other cheap generic that anchors an inflammatory condition, see our methotrexate cost guide. If your gout has produced kidney stones, our kidney stone surgery cost guide covers that bill, and if you are taking Lodoco for cardiovascular reasons, our atorvastatin cost guide prices the drug most often sitting next to it.