How Much Does Crestor (Rosuvastatin) Cost in Arkansas in 2026?

Brand vs. Generic Pricing in Arkansas

Generic rosuvastatin calcium has replaced brand Crestor as the default dispensed product in almost every Arkansas pharmacy. The price gap is enormous. AstraZeneca's branded Crestor carries a wholesale acquisition cost near $290 per month, while generic rosuvastatin tablets average roughly $15 per month at cash-pay prices across the state's retail chains.

Rosuvastatin lost patent exclusivity in 2016, and by 2026, multiple generic manufacturers supply the U.S. market. Arkansas pharmacies stock generics from Aurobindo, Teva, Hikma, and others. Because competition among generics is strong, per-tablet costs have dropped year over year. At most large-chain pharmacies in Little Rock, Fayetteville, Fort Smith, and Jonesboro, a 30-day supply of rosuvastatin 10 mg or 20 mg typically rings up between $8 and $22 without insurance. That range depends on the dispensing pharmacy's contracted wholesaler and the specific manufacturer on shelf.

Brand Crestor is still manufactured and still prescribed occasionally. Some patients report tolerating one manufacturer's formulation better than another, and a small number of clinicians write "dispense as written" for brand. If your prescription specifies brand Crestor without a generic substitution, expect to pay the full $290 list price unless insurance covers it or the pharmacy applies a discount card. The FDA's approved labeling for Crestor lists indications including primary hyperlipidemia, mixed dyslipidemia, hypertriglyceridemia, primary dysbetalipoproteinemia, homozygous familial hypercholesterolemia, and slowing atherosclerosis progression [1].

For context on clinical value at these prices: the JUPITER trial (N=17,802) demonstrated that rosuvastatin 20 mg daily reduced LDL cholesterol by 50% and cut the composite cardiovascular event rate by 44% compared to placebo in apparently healthy individuals with elevated high-sensitivity C-reactive protein [2]. That level of risk reduction, now available for $15 a month in generic form, makes rosuvastatin one of the most cost-effective cardiovascular drugs dispensed in Arkansas.

Arkansas Medicaid Coverage for Rosuvastatin

Arkansas Medicaid covers rosuvastatin, but a limited prior authorization requirement applies. The state's preferred drug list (PDL) places generic rosuvastatin among covered statins, though the specific tier and PA criteria are updated periodically by the Arkansas Department of Human Services Drug Utilization Review (DUR) Board.

Prior authorization for rosuvastatin under Arkansas Medicaid typically requires documentation of a diagnosis of hyperlipidemia or atherosclerotic cardiovascular disease (ASCVD) risk factors, along with evidence that the patient meets prescribing criteria in the 2018 AHA/ACC cholesterol guideline [3]. The PA process usually takes 24 to 72 hours. Denials can be appealed, and prescribers can request expedited review for patients with LDL above 190 mg/dL or documented ASCVD.

For Medicaid beneficiaries who qualify, the copay is minimal. Most Arkansas Medicaid recipients pay $0 to $3 per generic statin prescription. Brand Crestor is covered only if the prescriber demonstrates medical necessity for the brand product specifically, a requirement that is difficult to meet since the FDA considers approved generics therapeutically equivalent (AB-rated).

Arkansas expanded Medicaid under the ARHOME program, which replaced the previous Arkansas Works model. Adults aged 19 to 64 earning up to 138% of the federal poverty level are eligible. According to data from the Centers for Medicare and Medicaid Services, Arkansas had over 300,000 Medicaid expansion enrollees as of early 2025 [4]. That population carries a high prevalence of cardiovascular risk factors, and statin prescribing volume in the state reflects this burden.

The 2013 ACC/AHA guideline on treatment of blood cholesterol identified four statin benefit groups and recommended high-intensity statin therapy (rosuvastatin 20 to 40 mg qualifies) for patients with clinical ASCVD, LDL of 190 mg/dL or higher, diabetes aged 40 to 75 with LDL 70 to 189 mg/dL, and patients with a 10-year ASCVD risk of 7.5% or higher [5]. Arkansas Medicaid PA criteria generally align with these benefit groups.

Is Compounded Rosuvastatin Legal in Arkansas?

Yes. Compounded rosuvastatin is legal in Arkansas when prepared by a pharmacy operating under a valid 503A license. Section 503A of the Federal Food, Drug, and Cosmetic Act permits licensed pharmacies to compound medications based on individual prescriptions, and the Arkansas State Board of Pharmacy regulates compliance at the state level.

A 503A compounding pharmacy in Arkansas can prepare rosuvastatin in alternative dosage forms. Examples include suspensions for patients who cannot swallow tablets, custom-dose capsules for pediatric patients with familial hypercholesterolemia, or formulations that omit specific inactive ingredients for patients with documented allergies. Compounded rosuvastatin is not AB-rated to commercial tablets and is not interchangeable with FDA-approved products at the pharmacy counter without a prescriber's explicit order.

Compounding can sometimes reduce cost further. Some 503A pharmacies in Arkansas price compounded rosuvastatin capsules competitively with generic tablets, though pricing varies by pharmacy. Patients considering compounded rosuvastatin should verify that their pharmacy holds a current 503A registration and follows FDA compounding guidance [6]. 503B outsourcing facilities (which compound without individual prescriptions) may also supply rosuvastatin to clinics, but 503A remains the standard path for individual patient prescriptions in Arkansas.

Insurance Coverage Beyond Medicaid

Most commercial insurance plans sold in Arkansas cover generic rosuvastatin on their formulary. Plans offered through the Health Insurance Marketplace (healthcare.gov), employer-sponsored plans, and Medicare Part D plans all typically include rosuvastatin as a preferred generic statin.

Here is what to expect by plan type:

Marketplace (ACA) plans: Arkansas Marketplace plans must cover at least one drug per therapeutic class. Every major insurer offering plans on the Arkansas exchange (including Ambetter, QualChoice, and Blue Cross Blue Shield of Arkansas) includes generic rosuvastatin on their formulary. Copays for preferred generics typically range from $0 to $15 per fill.

Employer plans: Large employer plans in Arkansas commonly place generic rosuvastatin on Tier 1 (preferred generic), with copays of $5 to $20. Brand Crestor, when covered, sits on Tier 3 (preferred brand) or Tier 4 (non-preferred brand), with copays of $40 to $80 or coinsurance of 20% to 40%.

Medicare Part D: The 2022 Inflation Reduction Act provisions that took effect in 2025 capped Medicare Part D out-of-pocket costs at $2,000 per year [7]. For a generic statin like rosuvastatin that costs $15 a month, most Medicare beneficiaries pay well under the cap. Many Part D plans in Arkansas charge $0 to $10 for preferred generic rosuvastatin.

TRICARE: Covers generic rosuvastatin at military treatment facilities (no cost) or through the TRICARE retail pharmacy network ($14 copay for a 30-day supply of a generic in 2026).

Dr. Scott Grundy, lead author of the 2018 AHA/ACC Cholesterol Clinical Practice Guideline, stated: "High-intensity statin therapy remains the foundation of LDL-cholesterol lowering for patients at highest cardiovascular risk" [3]. Generic availability makes rosuvastatin one of the most accessible high-intensity statin options for Arkansas patients across all insurance types.

Discount Programs and Savings Cards

Even without insurance, several programs can reduce rosuvastatin costs for Arkansas residents below the $15 average cash price.

GoodRx and RxSaver coupons: Free discount cards from GoodRx, RxSaver, and similar aggregators pull pricing from pharmacy benefit managers and can drop generic rosuvastatin to $4 to $10 at Walmart, Kroger, CVS, and Walgreens locations in Arkansas. Prices fluctuate by week and by location, so checking multiple aggregators before each fill is worth the 60 seconds it takes.

Walmart $4 list: Walmart's $4 generic drug program includes rosuvastatin 5 mg, 10 mg, and 20 mg tablets (30-day supply). Arkansas has over 120 Walmart pharmacy locations, making this one of the most accessible discount options in the state. The 90-day supply price is $10.

AstraZeneca savings programs: AstraZeneca offered a Crestor savings card for commercially insured patients. Eligible patients could reduce brand Crestor copays to as low as $3 per fill. These programs typically exclude government insurance (Medicaid, Medicare, TRICARE). Verify current program availability directly with AstraZeneca, as manufacturer programs change terms periodically.

Patient assistance programs (PAPs): Uninsured or underinsured patients may qualify for free brand Crestor through AstraZeneca's patient assistance program, AZ&Me. Eligibility is income-based, generally requiring household income below 300% of the federal poverty level. Applications require prescriber involvement and proof of income.

340B pharmacies: Federally qualified health centers (FQHCs) in Arkansas participate in the 340B Drug Pricing Program, which provides outpatient drugs at significantly reduced prices [8]. Patients treated at FQHCs in Arkansas (including ARcare, Lee County Cooperative Clinic, East Arkansas Family Health Center, and Boston Mountain Rural Health Center) may access rosuvastatin at 340B pricing passed through to the patient.

Telehealth Prescribing of Rosuvastatin in Arkansas

Arkansas permits telehealth prescribing of rosuvastatin. The state has maintained its telehealth-friendly regulatory framework since the COVID-19 era expansions, and the Arkansas State Medical Board allows licensed physicians to prescribe Schedule VI (non-controlled) medications like statins via audio-video telemedicine visits.

A telehealth visit for statin prescribing typically works like this: you complete an intake questionnaire, provide recent lipid panel results (or get lab work ordered), and consult with a licensed prescriber via video. The prescriber evaluates your cardiovascular risk profile, reviews your medication history, and sends a rosuvastatin prescription to your preferred Arkansas pharmacy electronically.

The American Heart Association's 2019 primary prevention guideline recommends a clinician-patient risk discussion before initiating statin therapy in the intermediate-risk group (10-year ASCVD risk 7.5% to 19.9%) [9]. Telehealth platforms must support this shared decision-making process, not simply rubber-stamp prescriptions. Expect your telehealth prescriber to review your 10-year ASCVD risk score (calculated from the pooled cohort equations), discuss potential benefits and side effects, and establish follow-up lab monitoring at 4 to 12 weeks after initiation.

For Arkansas residents in rural counties where the nearest endocrinologist or cardiologist may be 90 minutes away, telehealth access to statin prescribing removes a real barrier. Rosuvastatin does not require in-person procedures, physical exams beyond blood pressure (which can be done at a local pharmacy kiosk), or controlled-substance oversight, making it well suited for telehealth management.

Rosuvastatin Dosing and Clinical Context

Rosuvastatin is prescribed at doses of 5 mg, 10 mg, 20 mg, and 40 mg, taken once daily. The dose depends on the patient's LDL-cholesterol target, baseline risk, and tolerability. High-intensity statin therapy (rosuvastatin 20 to 40 mg) targets a 50% or greater reduction in LDL cholesterol. Moderate-intensity therapy (rosuvastatin 5 to 10 mg) targets a 30% to 49% reduction.

The JUPITER trial enrolled 17,802 apparently healthy men aged 50 and older and women aged 60 and older with LDL cholesterol below 130 mg/dL but high-sensitivity CRP of 2.0 mg/L or higher [2]. Rosuvastatin 20 mg reduced the primary composite endpoint (myocardial infarction, stroke, arterial revascularization, hospitalization for unstable angina, or cardiovascular death) by 44% (hazard ratio 0.56, 95% CI 0.46 to 0.69, P<0.00001). The trial was stopped early at a median follow-up of 1.9 years because of the clear benefit signal.

A 2024 Cochrane systematic review of statins for primary prevention confirmed that statin therapy reduces all-cause mortality (OR 0.86, 95% CI 0.79 to 0.94), major vascular events, and coronary events in people without established cardiovascular disease [10]. These data support statin prescribing across the risk spectrum defined by current guidelines.

Side effects to discuss with your prescriber include myalgia (reported in 5% to 10% of patients in observational studies, though nocebo-controlled trials such as StatinWISE (BMJ 2021) found muscle symptom rates similar between statin and placebo periods) [11], liver enzyme elevation (rare, occurring in fewer than 1% of patients), and new-onset diabetes (a modest increase in risk, approximately 1 additional case per 250 patients treated for 4 years, per the JUPITER diabetes substudy) [12].

The Endocrine Society's 2020 guideline on lipid management in endocrine disorders noted: "Statin benefit in reducing ASCVD events far outweighs the modest diabetes risk in most patient populations" [13]. For Arkansas patients weighing the cost-benefit of starting rosuvastatin, this risk context matters.

How to Get the Lowest Price on Rosuvastatin in Arkansas

The practical steps to minimize your rosuvastatin costs in Arkansas break down by insurance status.

If you have commercial insurance: Check your formulary. Generic rosuvastatin is almost certainly covered. If your copay exceeds $15, ask your pharmacist to run the cash price alongside your insurance. Sometimes the cash price is lower than the insured copay, and pharmacists in Arkansas are permitted to inform you of this under the state's gag-clause ban.

If you have Arkansas Medicaid: Your prescriber may need to submit a prior authorization. Provide your Medicaid ID at the pharmacy. Generic rosuvastatin copay should be $0 to $3.

If you have Medicare Part D: Verify rosuvastatin is on your plan's formulary using the Medicare Plan Finder at medicare.gov. Most Part D plans charge $0 to $10 for generic rosuvastatin.

If you are uninsured: Use a GoodRx or RxSaver coupon. Fill at Walmart ($4 for 30 days). Apply for AstraZeneca's patient assistance program if you need brand Crestor. Visit a 340B-eligible FQHC for reduced-cost prescribing and dispensing.

If you prefer telehealth: Schedule a visit through a licensed telehealth platform that operates in Arkansas. Have a recent lipid panel (within 12 months) available, or plan to get labs drawn before or shortly after your visit. The prescriber will send the prescription to your local pharmacy, where the same pricing rules apply.

Rosuvastatin 10 mg once daily at Walmart in Arkansas costs $4 for a 30-day supply, or roughly $0.13 per day.