Donepezil vs Pyridostigmine — Cost, Coverage & Plan Comparison

Pick the drugs you want to compare.

Up to 4 drugsCross-class or same-class

Start with the molecules your plan spends the most on. Most useful comparisons live within the same therapeutic class — switching across classes requires deeper clinical review.

Drug 1

Drug 2

Drug 3 (optional)

Drug 4 (optional)

Side by side, line by line.

Federal data onlyNo PBM pricing assumed

Compare across

11 dimensions

Cholinesterase Inhibitor

Donepezil

Brand: Aricept

First FDA approval: 1996-11-25

Cholinesterase Inhibitor

Pyridostigmine

Brand: Mestinon

First FDA approval: 1955-04-06

Lowest NADACAcquisition cost floor across all NDCs

$0.044Per unit

$0.273Per unit

Average NADACAcross all dosage forms and strengths

$0.131Up to $0.729

$1.62Up to $6.93

Generic manufacturersActive ANDA holders — FDA Orange Book

2041 total ANDAs filed

1113 total ANDAs filed

Annualized Part D spendCY2024 — CMS Part D Spending Dashboard

$158.0MFull year

$57.5MFull year

Part D claims (CY24)Total fills, all strengths

12.3M2.9M beneficiaries

424K125K beneficiaries

Avg cost per claimCalculated: total spend ÷ total claims

$13Per claim, all NDCs

$136Per claim, all NDCs

Part D plans surveyed2026 plan year — CMS Formulary file

329Across CMS plan year

Prior-authorization frictionPlan-NDC pairs requiring PA

0Zero PA friction

Step therapy appliedPlan-NDC pairs requiring step therapy

3Limited friction

0None

FDA shortage statusLive cross-reference vs FDA Drug Shortage Database

NoneClear

Generic availableFDA Orange Book

Yes20 manufacturers

Yes11 manufacturers