Ezetimibe is the generic name for Zetia, a once-daily tablet that blocks cholesterol absorption in the small intestine. FDA approved brand Zetia on October 25, 2002 as a new molecular entity, and the first generic arrived in June 2015. It is one of the very few cholesterol drugs that costs a cash payer almost nothing, which makes it unusual on a shelf where the newer options run into the hundreds or thousands per month.
That said, the spread on this molecule is wild. The same 10 mg tablet is priced anywhere from about 7 cents to $14.50 depending on whether you are buying the generic or the brand, and the combination pills that pair ezetimibe with a statin cost several times what the two separate generics cost. Everything below was researched on September 3, 2026.
What Does Ezetimibe Cost Without Insurance?
Acquisition costs come from CMS NADAC, the federal survey of what pharmacies actually pay, using the vintage effective August 19, 2026. Retail cash prices come from Cost Plus Drugs, Drugs.com and SingleCare, all read on September 3, 2026. Where a per-tablet figure is published, the 30-day arithmetic is shown so you can check it.
| Option | Low | Average | High |
|---|---|---|---|
| Generic ezetimibe 10 mg, 30 tablets, Cost Plus Drugs | $6.38 | $6.38 | $6.38 plus $5 shipping |
| Generic ezetimibe 10 mg, 30 tablets, retail cash | $7.93 | $13.69 (midpoint) | $19.44 |
| Generic ezetimibe 10 mg, 90 tablets, SingleCare card | $13.89 | $13.89 | $13.89 |
| Generic ezetimibe, 30-day NADAC acquisition cost | $2.02 | $2.02 | $2.02 |
| Generic ezetimibe-simvastatin, 30 tablets | $7.24 (Cost Plus) | $8.17 (Cost Plus, 10-80 mg) | $39.93 (Drugs.com) |
| Brand Zetia 10 mg, 30 tablets | $418.93 | $434.92 | $524.68 |
| Brand Vytorin, 30 tablets | $408.62 | $414.10 | $430.84 |
| Ezetimibe plus a separate generic statin, 30 days (NADAC) | $2.95 (simvastatin 20 mg) | $3.13 (rosuvastatin 10 mg) | $3.13 |
The NADAC line is the anchor. CMS recorded generic ezetimibe 10 mg at $0.06747 per tablet effective August 19, 2026, so a 30-day supply costs a pharmacy $2.02 to buy. Brand Zetia in the same file sits at $13.96419 per tablet, or $418.93 for 30. That is a 207-fold gap between the brand and generic version of an identical molecule.
Retail cash prices land above acquisition cost, as they should, but not by much. Cost Plus Drugs publishes $6.38 for 30 tablets against a $113.40 comparison price it lists for other pharmacies. Drugs.com reports a cash range of $7.93 to $19.44 for 30 tablets ($0.26 to $0.65 per unit) and $12.49 to $42.71 for 90.
Where the sources genuinely disagree
SingleCare’s ezetimibe page, updated September 3, 2026, states an average retail price of $850.46 for 90 tablets. That is $283 a month, and it is wildly out of line with the $12.49 to $42.71 that Drugs.com reports for the same 90 tablets. The same SingleCare page offers a card price of $13.89 for those 90 tablets.
We are publishing the cross-source range rather than picking a winner, but the practical read is that the low figures are the real ones and the “average retail” number reflects unhelped fills at counters that never applied a generic price. Treat the $283 as what happens if you ask no questions, not as the market price.
What Drives the Price
Brand versus generic. This is the single biggest lever. Seventeen abbreviated applications containing ezetimibe are approved as of September 2026, the first to Glenmark in June 2015, so pharmacies have deep generic supply and substitute automatically in most states.
Whether you buy a combination pill. Ezetimibe-simvastatin costs several times what its two components cost separately. More on that below.
Quantity. Ninety-day fills cut the per-month cost meaningfully. Drugs.com’s 90-count range starts at $12.49, about $4.16 a month, against $7.93 for 30 days.
Whether you use a card or a transparent pharmacy. The gap between a card price and an unhelped counter price on this drug is the difference between under $10 and a three-figure bill.
Region and pharmacy. NADAC is a national average and every published retail figure is a national estimate. Independent pharmacies, grocery chains and big-box counters price the same tablet differently in the same ZIP code.
The Combination Pills and the Math That Matters
Two combination products pair ezetimibe with a statin, and both are worth checking against the separate generics before you fill.
Vytorin (ezetimibe-simvastatin), Organon. The generic exists in four strengths. NADAC prices them at $0.22784 to $0.34920 per tablet effective August 19, 2026, which is $6.84 to $10.48 for 30 days. Cost Plus Drugs sells the four strengths at $7.24, $7.59, $7.86 and $8.17 for 30 tablets. Drugs.com reports a higher cash range of $36.66 to $39.93 for 30, which is another genuine cross-source spread on this cluster. Brand Vytorin is $408.62 to $430.84 for 30 tablets.
Now the comparison. Generic ezetimibe plus generic simvastatin 20 mg, bought as two prescriptions, costs about $2.95 for 30 days at NADAC acquisition cost ($2.02 plus $0.93). The generic combination tablet at the matching strengths costs about $6.84. The combination is roughly 2.3 times the price for the same two active ingredients.
Roszet (ezetimibe-rosuvastatin), Althera. FDA approved it March 23, 2021, but Drugs@FDA lists all four strengths as Discontinued as of September 2026. Drugs.com still publishes a $272.75 cash price for 30 tablets, which is the kind of stale listing worth knowing about before you go looking for it. There is no generic ezetimibe-rosuvastatin in NADAC either. Ezetimibe plus generic rosuvastatin 10 mg separately costs about $3.13 for 30 days at acquisition cost.
The takeaway is not that combination pills are bad. It is that on this particular shelf, one pill a day is a convenience purchase costing a couple of dollars a month extra, not a discount.
Cash Price vs. Insurance
Ezetimibe is one of the clearest cases where paying cash can beat running a claim. If your plan’s generic copay is $10 or $15, you are paying more than the $6.38 Cost Plus charges and more than the $4.63 a month a 90-day SingleCare fill works out to. On a drug this cheap, the copay is often the entire price.
The tradeoff is deductible credit. A cash purchase does not count toward your plan’s deductible or out-of-pocket maximum, and a discount card fill generally does not either. On a $6 medication that credit is not worth much, but if you are close to hitting a deductible for something else, run the claim.
For brand Zetia the calculation is different and simpler. Almost nobody should be paying a brand price for this molecule. If your prescription says Zetia and your pharmacy is quoting three figures, ask whether it can be filled as generic ezetimibe. Our fair price checker is a quick sanity test on any quote you are handed.
One more insurance note specific to cholesterol care: the drug is the cheap part. The lipid panel, the follow-up visits and any imaging are where cash payers get hit. Budget for blood work and, if your prescriber orders one, a coronary calcium score.
How to Pay Less
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Fill 90 days at a time. Drugs.com’s 90-count cash range starts at $12.49, roughly $4.16 a month, and SingleCare’s card price of $13.89 for 90 tablets is about $4.63 a month. Both beat any 30-day price on this page.
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Price a transparent mail pharmacy. Cost Plus Drugs publishes $6.38 for 30 tablets with its markup shown openly, against the $113.40 it lists as the comparison retail price. Shipping is $5 on standard orders, so a 90-day fill amortizes it better.
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Run both discount cards on the same fill. The card prices on this molecule are so low that the difference between cards is usually pennies, but the difference between using a card and not using one is a hundred dollars or more. Our comparison of GoodRx vs. SingleCare covers how to check both without paying anything.
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Never accept the brand quote without asking. Brand Zetia and brand Vytorin both cost more than $400 for 30 tablets while their generics cost single digits. Ask the pharmacist directly whether a generic substitution is available on your prescription.
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Buy the components separately if you are on a combination. Two generic prescriptions cost about $3 a month at acquisition cost. The combination tablet costs two to three times that. This is a conversation to have with your prescriber, not a swap to make on your own.
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Get the prescription written cheaply. A free or sliding-scale clinic can handle the prescribing and the lipid monitoring at little or no cost. If a bill from a previous visit is already outstanding, our guide to negotiating medical bills covers what to say.
Bottom Line
Budget $5 to $19 a month for generic ezetimibe and treat anything above $25 as a signal to shop. The floor is about $4 a month if you fill 90 days with a card, and the ceiling is only reached if you hand over a prescription at a counter and ask nothing.
Ezetimibe is the cheap end of the cholesterol shelf, and that context matters when a prescriber suggests something newer. Generic statins are cheaper still, at roughly $1 a month at acquisition cost for atorvastatin or rosuvastatin. Everything else costs dramatically more: Nexletol runs about $390 to $593 a month with no generic, and the injectables Repatha, Praluent and Leqvio are in a different price category entirely. Knowing what the $6 option costs is what makes those numbers legible.