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But hydrochlorothiazide, a blood pressure medication, is just 3 cents a pill, or 90 cents for 30 days. Another blood pressure medication, metoprolol tartrate, is just 2.3 cents a pill, or 60 cents for 30 days. Belk calls it the pharmacies' dirty little secret.“They don’t want you to know that because the insurance co-pay is actually the biggest profit most chain pharmacies get,” he said.Daniel Barbara, executive director of the North Carolina Association of Pharmacists, disagrees.Target pharmacist Thomas Sinodis says people are often surprised to learn that their medications can cost more with insurance."Sometimes they’re like, 'But my co-pay is ,' and we’ll have to explain, 'Actually, this is on our list, so it’s only going to be this month,'" Sinodis said.Belk says it's "only the chain pharmacies that sell it to you for your insurance co-pay that are most of the time ripping you off."WRAL Investigates researched how much pharmacies actually pay for pills.Between Target, Walmart, Kroger and Costco, if Grimes shopped around, she could save 6 a year.Belk says those retailers are not taking a loss on the generic drugs.“They’re still selling it as a profit,” he said.

If no one’s talking about it, no one knows, and they get away with it,” he said.He says the co-pay “off-sets the cost to the insurance company, not the pharmacy.Often times, the co-pay is substantially more than the profit made by the pharmacy.""As with most issues in business and health care, the issue of co-pays and medication costs is not nearly as a simple as it would appear from a cursory review of the subject," Barbara said in a statement.He says there’s much more to drug pricing than the pills.“For a lot of companies, generics are a way to bring people in the store and buy other things while in the store,” Farley said.“They’re able to offer that because the ingredient costs of medication are less than , but I don’t think they’re adequately building in cost of dispensing medication (and the) cost of clinical consultation the pharmacist has, for example.”Farley points out the important role pharmacists have in making sure patients are getting the right drugs and checking for drug interactions and side effects.

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