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 |  | With Health Insurance: $10-$85+ Prescription Copay |  | Without Health Insurance: $20-$450+ |
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Cold sores are bumps or blisters on the lips, mouth or face caused by the herpes simplex virus. Formally known as herpes simplex, cold sores typically go away on their own, but treatment can ease symptoms such as pain and itching and help speed healing -- or, it can reduce the number and severity of outbreaks.
Typical costs: | - For patients covered by health insurance, out-of-pocket costs for cold sore treatment typically consist of up to $20 for an over-the-counter medication or a prescription drug copay of $10-$85 or more, depending on the plan and whether the drug is generic, preferred or non-preferred. Cold sore treatment typically is covered by health insurance.
- For patients not covered by health insurance, the cost of cold sore diagnosis typically includes a doctor visit and, in rare cases, a lab test fee. For example, AnyLabTestNow.com charges $49 for a herpes simplex lab test[1] . And cold sore treatment typically costs less than $20 for an over-the counter ointment that provides symptom relief only -- or, in the case of Abreva[2] , shortens healing time. For example, Drugstore.com charges about $2-$20 for over-the-counter cold sore medication[3] .
- Treatment costs from less than $5 to a little more than $360 per bottle (or less than $5-$150 per outbreak) for the most commonly prescribed oral medications that, according to a Journal of Family Practice report[4] , are the most effective treatments available and can shorten the duration of an outbreak by about a day. For example, Walmart offers generic acyclovir[5] for $4 per bottle. Drugstore.com charges about $340 for a 30-count bottle of generic valacyclovir and about $365 for the brand-name equivalent, Valtrex. And Drugstore.com charges about $30 for a 60-count bottle of generic acyclovir, and about $360 for the brand-name equivalent Zovirax.
- Treatment costs about $325-$450 per bottle for the less commonly prescribed oral medication, famciclovir. Drugstore.com charges about $325 for a 30-count bottle of generic famciclovir and about $450 for the brand-name equivalent Famvir.
- Based on estimated prescription dosages[6] from eMedicinehealth.com, the per-outbreak costs would be: less than $4 to $14 for acyclovir, $33 for famciclovir, $45 for Famvir, $45 for valacyclovir, $48 for Valtrex and $150 for Zovirax.
- Expect to pay up to $200 or more for a tube of a prescription topical medication to relieve symptoms and possibly shorten healing time by about half a day. Drugstore.com charges about $180 for a tube of prescription Denavir cream and about $210 for a tube of prescription Zovirax.
Related articles: STD Testing, Health Insurance
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What should be included: | - A doctor typically can diagnose a cold sore with a visual examination.
- Most over-the counter cold sore creams such as Zilactin[7] and Anbesol Cold Sore Therapy, contain numbing ingredients such as lidocaine, benzocaine or tetracaine, and can only relieve symptoms. Only one over-the-counter medication, Abreva[8] , has been approved by the U.S. Food and Drug Administration to shorten the duration of cold sores.
- Prescription topical anti-viral medications, such as Zovirax[9] , or oral medications, such as Valtrex[10] , work by targeting the mechanism by which the herpes virus multiplies. These medications can relieve symptoms and shorten the duration of the outbreak or, if taken as soon as symptoms appear, can sometimes prevent sores from forming.
- WebMD has an overview of cold sore treatment[11] .
Additional costs: | - To help prevent cold sores, it is recommended in between outbreaks to wear sunscreen and lip balm with sun protection, which usually cost less than $10. For example, Herpecin-L lip balm[12] costs about $6.
Discounts: | - The U.S. Department of Health and Human Services offers a locator[13] for clinics with sliding fee scales based on income.
- Some drug manufacturers offer patient assistance programs. Any patient without prescription drug coverage who also is not eligible for Medicare typically qualifies for Together Rx Access[14] , a discount card that offers 25-40% off many brand-name drugs.
- Some companies offer coupons or rebates to lower copays for patients with prescription drug coverage. For example, Denavir.com has a coupon[15] to limit the copay to $15 for eligible patients on copays up to $60. Zovirax.com offers a similar discount.
Shopping for cold sore treatment: | - A family doctor can diagnose and prescribe treatment for cold sores. The American Medical Association offers a doctor locator[16] , and FindUrgentCare.com offers an urgent care center locator[17] .
- The Mayo Clinic offers a guide to cold sore symptoms[18] , what a cold sore looks like and when to see a doctor for a possible cold sore.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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External Resources: | - www.anylabtestnow.com/for-individuals/stds/
- www.abreva.com/
- www.drugstore.com/search/search_results.asp?N=0&Ntx=mode%2Bmatchallpartial&Ntk=All&srch...
- www.jfponline.com/Pages.asp?AID=5151
- i.walmartimages.com/i/if/hmp/fusion/customer_list.pdf
- www.emedicinehealth.com/cold_sores/page7_em.htm
- www.blairex.com/BLZilactin-B.php
- www.abreva.com/
- www.zovirax.com/
- us.gsk.com/products/assets/us_valtrex.pdf
- www.webmd.com/skin-problems-and-treatments/tc/cold-sores-treatment-overview
- www.drugstore.com/herpecin-l-lip-balm-stick-spf-30/qxp15808
- findahealthcenter.hrsa.gov/Search_HCC.aspx
- www.togetherrxaccess.com/p/prescription-savings/about-together-rx-access/enroll.aspx
- www.denavir.com/
- extapps.ama-assn.org/doctorfinder/recaptcha.jsp
- www.findurgentcare.com/
- www.mayoclinic.com/health/cold-sore/DS00358/DSECTION=symptoms
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