Walmart started the retail $4 generic in 2006 and the number has never moved, which is most of why people still search for it twenty years later. What has changed is the shape of the program around that number. It is now four price tiers, not one, and the tier your specific drug and strength lands in decides whether you pay $4 or $24 for the same month of medicine.
The complication is that Walmart’s website does not show you the tiers. The $4 Prescriptions page advertises “30-day supply of medications starting as low as $4” and links out to a PDF drug list, and the PDF is where the $9, $15 and $24 tiers actually live. Below is what that list said when it was pulled and parsed on September 4, 2026, plus what the program excludes and what happens when your drug is not on it.
What Does a Prescription Cost at Walmart Pharmacy?
Every figure in this table comes from Walmart’s own program list, which carries an effective date of March 24, 2025 and was still the live document linked from walmart.com on September 4, 2026. The quantity column matters as much as the price: Walmart prices a 30-day supply, not 30 tablets, so a twice-daily drug is 60 tablets for $4 or $9.
| Program tier | 30-day price | 90-day price | Example drugs on that tier |
|---|---|---|---|
| Tier 1 | $4 | $10 | Levothyroxine (all 11 strengths), atenolol, furosemide, hydrochlorothiazide, clonidine, ramipril, warfarin, amitriptyline, nortriptyline, paroxetine 20/30 mg, folic acid |
| Tier 2 | $9 | $24 | Metformin (60 tabs), lisinopril, losartan, amlodipine, metoprolol, simvastatin, sertraline 25/100 mg, fluoxetine, citalopram, trazodone, quetiapine, birth control |
| Tier 3 | $15 | $38 | Bupropion (all forms), venlafaxine and venlafaxine ER, methocarbamol 750 mg, viscous lidocaine 2% |
| Tier 4 | $24 | not offered | Albuterol HFA, one inhaler, preferred version of Proventil HFA only |
| Walmart Mail Service | not offered | $10 or $24 | 90-day mail delivery only; not all retail-tier drugs are covered by mail |
| Off the list | not published | not published | Walmart publishes no cash price for drugs outside the program |
| Rx home delivery fee | $9.95 | $9.95 | Free with Walmart+ ($98/year or $12.95/month) |
For scale: CMS’s National Average Drug Acquisition Cost survey, effective August 19, 2026, prices lisinopril 10 mg at $0.01832 a tablet and metformin 500 mg at $0.01419. Thirty lisinopril tablets cost a pharmacy about 55 cents. So $4 is a real retail price with a real margin in it, not a loss leader in any meaningful sense.
The Walmart $4 List: What Is Actually On It
The list is organized by condition, and each block carries its own price badge. Getting the badge attached to the right block is the thing most third-party summaries get wrong, so here is what a coordinate-level read of the March 2025 document shows.
The $4 / $10 tier
Heart and blood pressure: atenolol 25/50/100 mg, clonidine 0.1/0.2/0.3 mg (60 tablets for 30 days), furosemide 20/40/80 mg, hydralazine 10/25/50 mg (90 tablets for 30 days), hydrochlorothiazide 12.5/25/50 mg, indapamide, lisinopril-HCTZ 20/25, losartan-HCT 50/12.5, ramipril, triamterene-HCTZ, and warfarin at every strength from 1 mg to 10 mg.
Thyroid: levothyroxine at 25, 50, 75, 88, 100, 112, 125, 137, 150, 175 and 200 mcg, all at $4 for 30 tablets. That is the single most valuable line on the list, because levothyroxine is one of the most-dispensed drugs in the country.
Mental health: amitriptyline 10/25/50/75 mg, nortriptyline 10/25/50 mg, paroxetine 20 and 30 mg, lithium carbonate 300 mg capsules, trihexyphenidyl 2 mg. Plus metoclopramide 5/10 mg and folic acid 1 mg.
The $9 / $24 tier
This is where most of the volume actually sits. Diabetes: glimepiride, glipizide, glipizide ER, glyburide-metformin, metformin 500/850/1000 mg and both extended-release strengths. Cholesterol: fenofibrate 145 mg, gemfibrozil 600 mg and simvastatin 10/20/40 mg, which is the only statin on the list at any tier.
Blood pressure and heart: amlodipine, benazepril, bisoprolol, diltiazem, doxazosin, enalapril, irbesartan, isosorbide mononitrate ER, lisinopril 2.5 through 30 mg, losartan, metoprolol ER and metoprolol tartrate, spironolactone, torsemide, valsartan-HCTZ, verapamil ER, chlorthalidone, digoxin, amiodarone and nitroglycerin.
Mental health and neurology: sertraline 25 and 100 mg (note: not 50 mg), fluoxetine, citalopram, mirtazapine, trazodone, quetiapine, risperidone, lamotrigine, levetiracetam, topiramate, oxcarbazepine, divalproex, donepezil, buspirone, carbidopa-levodopa, pramipexole and ropinirole. Family planning: norethindrone 0.35 mg, Sprintec and Tri-Sprintec at $9 for a 28-day pack.
What is not on the list at all
Walmart’s own FAQ states that “antibiotics, antihistamines and steroids are not included in the $4 Prescription Program.” A parsed search of the March 2025 document backs that up and goes further: there is no atorvastatin, rosuvastatin or pravastatin, no gabapentin, no omeprazole or pantoprazole, no montelukast, no escitalopram or duloxetine, no meloxicam and no insulin at any tier. If you take one of those, the program is irrelevant to you and Walmart publishes no cash price for it anywhere on its site.
What Drives the Price
Which tier your exact strength lands in. The list is strength-by-strength. Lisinopril 2.5 to 30 mg is $9, but lisinopril-HCTZ 20/25 is $4. Sertraline 25 and 100 mg are on the list and 50 mg is not. Ask the pharmacy to check your exact strength before assuming.
Days of supply, not tablet count. Metoprolol tartrate is listed as 60 tablets for a 30-day supply because it is dosed twice daily. Metformin is 60. Hydralazine is 90. A quote for 30 tablets of any of these is half a month, and the price will not be the tier price.
Formulation. Walmart’s program details state that “not all formulations of a drug (for example, enteric-coated, extended or timed release formulations) are covered,” and that program pricing is unavailable when a covered drug is dispensed as part of a compound.
Where you live. The program runs at every Walmart and Neighborhood Market pharmacy in the United States except North Dakota. Walmart also warns on both the program page and the drug list that prices may be higher or vary in some states, “including, but not necessarily limited to, CA and MN.”
Manufacturer stock. Program pricing “may be limited to select manufacturers of a covered drug and is available as long as supplies from such manufacturers are in stock at the dispensing pharmacy.” A shortage can push you off the program price without anyone telling you in advance.
Cash Price vs. Insurance
The program price is a cash price, and Walmart says outright in its program details that “you may pay less or more than the Program price, depending on the terms of your health plan.” That is the whole decision. If your copay on a generic is $10 and the program price is $4, do not hand over the insurance card.
The catch that trips people up is that a cash purchase does not generate a claim, so it does not count toward a deductible or an out-of-pocket maximum. On a $4 generic that is irrelevant. On a specialty drug it is not, which is a different calculation entirely.
Two logistics rules are worth knowing before you plan around the program. At retail, Walmart requires that prescriptions “must initially be filled in person, and refills must be picked up in store.” Home delivery of program drugs runs through Walmart Mail Service instead, at $10 for a 90-day supply or $24 for certain women’s health drugs, and Walmart notes that not every retail-tier drug is covered by mail.
How to Pay Less
Ask for 90 days. A $4 drug at 90 days is $10, so you save $2 a quarter, but a $9 drug at 90 days is $24 instead of $27 and a $15 drug is $38 instead of $45. Walmart says prescriber permission may be required to convert a 30-day prescription to a 90-day one.
Take the list to your appointment, not to the counter. The most expensive mistake is filling an off-list drug at an unpublished price when a listed alternative in the same class exists. That is a conversation for your prescriber, not the pharmacy, and it is worth having before the prescription is written.
Price off-list drugs at a cost-plus pharmacy. Cost Plus Drugs listed lisinopril 10 mg at $5.38 for 30 tablets on September 4, 2026 ($0.33 manufacturing, $0.05 markup, $5.00 pharmacy labor) plus $5.25 shipping, against Walmart’s $9. For drugs Walmart does not list at all, the gap gets much wider. See our Cost Plus Drugs price guide.
Compare a warehouse club before you assume Walmart wins. It usually does on the list and usually does not off it. Costco’s published mail-order cash price for atorvastatin 10 mg was $36.39 for 30 tablets on September 4, 2026, and Costco does not require a membership to use its pharmacy at all. Our Costco pharmacy price guide has the full comparison.
Run a free discount card at the same counter. Cards frequently beat $9 and $15 tier prices, and checking costs nothing. Our head-to-head on GoodRx vs. SingleCare covers where each tends to win.
Skip the delivery fee unless the math works. Walmart charges $9.95 per prescription delivery and waives it for Walmart+ members at $98 a year. That is roughly ten deliveries a year to break even on the pharmacy benefit alone.
If $4 is still too much, that is a solvable problem. Federally qualified health centers and free clinics dispense many of these same generics on a sliding scale. Our guide to free and sliding-scale clinics explains how to find one near you, and if you have already been billed for something you cannot pay, start with how to negotiate medical bills.
The Bottom Line
If your prescription is on Walmart’s list, Walmart is very hard to beat and the price is genuinely posted, which is rare in American healthcare. If it is not on the list, Walmart becomes an ordinary pharmacy with no published cash price, and you should be comparing it against Cost Plus Drugs, a discount card and a warehouse club rather than assuming the $4 reputation carries over.
Check your exact drug, strength and dosage form against the program list before you transfer anything, and use our fair price checker if you have been quoted a number that feels wrong. The list itself is dated March 24, 2025 and Walmart reserves the right to change program details without advance notice, so confirm at the counter for anything you are budgeting around. Common single-drug prices are broken out in our guides to metformin, levothyroxine, sertraline and albuterol inhalers.