Crestor (Rosuvastatin) Cost in New Hampshire 2026: Prices, Insurance, and Savings

What Rosuvastatin Actually Costs at New Hampshire Pharmacies

The gap between brand and generic pricing is enormous. AstraZeneca lists brand-name Crestor at approximately $290 per month for a 30-day supply of once-daily tablets. Generic rosuvastatin, available since 2016, averages roughly $15 per month at New Hampshire retail pharmacies in 2026.

That $15 figure reflects cash-pay pricing without insurance. Actual out-of-pocket costs depend on your specific plan, pharmacy, and dose. A 10 mg tablet and a 40 mg tablet of generic rosuvastatin typically cost the same per unit at most chains, so dose escalation does not necessarily increase your monthly expense.

Prices vary by pharmacy. Costco, Walmart, and regional independents in Manchester, Nashua, and Concord often undercut national chain prices by $2 to $5 per month for generic statins. The GoodRx and RxSaver discount platforms show New Hampshire rosuvastatin prices ranging from $4 to $18 depending on the chain and coupon applied. Price-shopping matters. Even among pharmacies in the same zip code, a twofold difference in cash price is common for this drug.

For patients who specifically require brand Crestor (rare, given bioequivalence of the generic), the $290 list price can be reduced through manufacturer copay cards. AstraZeneca has periodically offered savings programs, though eligibility and terms shift year to year. The FDA-approved prescribing information for Crestor confirms the generic and brand share identical active ingredients, dosing, and approved indications [1].

New Hampshire Medicaid and Rosuvastatin Coverage

New Hampshire Medicaid does not cover brand-name Crestor. The state's preferred drug list (PDL) includes generic rosuvastatin as the covered alternative within the HMG-CoA reductase inhibitor class.

This means Medicaid beneficiaries in New Hampshire can obtain generic rosuvastatin with a standard Medicaid copay, typically $1 to $3 per prescription. If a prescriber writes for brand Crestor specifically, the pharmacy will receive a rejection unless a prior authorization demonstrates medical necessity for the brand over generic. Such approvals are granted sparingly. The 2013 ACC/AHA cholesterol guideline and its 2018 update both support high-intensity statin therapy (rosuvastatin 20 to 40 mg) for secondary prevention, and the generic fulfills that recommendation identically to the brand [2].

New Hampshire expanded Medicaid under the Granite Advantage Health Care Program, which covers adults with incomes up to 138% of the federal poverty level. For these enrollees, generic rosuvastatin is accessible with minimal cost-sharing. Beneficiaries who face a Medicaid denial for brand Crestor should ask their prescriber to switch to the generic, which is therapeutically equivalent and universally covered.

According to a 2019 analysis in JAMA Internal Medicine, generic statin availability reduced annual per-patient spending on lipid-lowering drugs by over 80% in Medicaid populations nationally [3]. New Hampshire's decision to exclude brand Crestor from its PDL reflects this cost-effectiveness logic.

Insurance Coverage Beyond Medicaid

Most commercial health plans sold in New Hampshire place generic rosuvastatin on Tier 1 or Tier 2 of their formulary, resulting in copays of $0 to $15 per month. Brand Crestor, when covered at all, sits on a non-preferred brand tier (Tier 3 or higher) with copays of $40 to $75 or coinsurance of 25% to 50%.

Anthem Blue Cross Blue Shield, the largest insurer on the New Hampshire marketplace, covers generic rosuvastatin on its preferred generic tier. Cigna, Harvard Pilgrim, and Ambetter plans in the state follow a similar pattern. For employer-sponsored plans, formulary placement depends on the plan's pharmacy benefit manager (PBM), but Express Scripts, CVS Caremark, and OptumRx all classify generic rosuvastatin as a preferred generic.

High-deductible health plans (HDHPs) paired with health savings accounts (HSAs) are popular in New Hampshire, which has no state income tax. Under an HDHP, the patient pays the full negotiated rate for rosuvastatin until meeting their deductible. This negotiated rate for generic rosuvastatin is often $8 to $15, making it one of the cheapest medications to fill even before the deductible is met.

The 2018 AHA/ACC Cholesterol Clinical Practice Guideline recommends rosuvastatin 20 to 40 mg as one of two high-intensity statin options (alongside atorvastatin 40 to 80 mg), reinforcing why insurers prioritize coverage for this molecule [4]. Rosuvastatin earned its place on nearly every formulary in the country. New Hampshire is no exception.

Compounded Rosuvastatin in New Hampshire: Legal and Available

Compounded rosuvastatin is legal in New Hampshire when dispensed by a licensed 503A compounding pharmacy operating under a valid patient-specific prescription. Section 503A of the Federal Food, Drug, and Cosmetic Act permits compounding pharmacies to prepare customized formulations when a prescriber determines that a commercially available product does not meet a patient's needs [5].

Why would anyone compound a generic that already costs $15? A few scenarios apply. Patients who cannot swallow tablets may need a liquid suspension. Patients with allergies to specific inactive ingredients (dyes, fillers, lactose) in manufactured tablets may require a formulation without those excipients. Pediatric patients with familial hypercholesterolemia sometimes need dose forms not commercially available.

New Hampshire's Board of Pharmacy regulates 503A pharmacies within the state. Out-of-state 503A pharmacies can ship compounded rosuvastatin into New Hampshire provided they hold a non-resident pharmacy license and comply with NH RSA 318. The state does not impose additional restrictions on statin compounding beyond federal 503A requirements.

Compounded rosuvastatin pricing varies widely. Some telehealth platforms bundle compounded statins into subscription models at no additional drug cost. Others charge $20 to $45 per month. Patients considering compounded rosuvastatin should confirm the pharmacy's 503A registration, verify ingredient sourcing, and ensure their prescriber has documented a clinical reason for compounding over the commercially available generic.

Telehealth Prescribing of Rosuvastatin in New Hampshire

New Hampshire permits telehealth prescribing of rosuvastatin. The state enacted permanent telehealth parity legislation (HB 1623, effective 2021), which requires commercial insurers to cover telehealth services at the same rate as in-person visits. This includes the evaluation, diagnosis, and prescribing of medications for hyperlipidemia.

A New Hampshire-licensed prescriber can evaluate a patient via video or audio-only telehealth, review lipid panel results, and prescribe rosuvastatin electronically to any pharmacy in the state. No in-person visit is required for an initial statin prescription under current NH law, though best practice dictates reviewing recent lab work (lipid panel, liver enzymes, creatine kinase at baseline if risk factors are present).

Several national telehealth platforms operate in New Hampshire and include statin prescribing as part of cardiometabolic health programs. These platforms typically charge $30 to $75 per consultation or a monthly subscription fee that covers ongoing prescriptions and lab monitoring. For patients without a primary care physician, or for those in rural parts of the state (the North Country, for example, where specialist access is limited), telehealth provides a practical path to evidence-based statin therapy.

The JUPITER trial, which enrolled 17,802 apparently healthy individuals with LDL cholesterol <130 mg/dL and high-sensitivity C-reactive protein ≥2.0 mg/L, demonstrated that rosuvastatin 20 mg daily reduced major cardiovascular events by 44% compared to placebo (hazard ratio 0.56; 95% CI, 0.46 to 0.69; P<0.00001) over a median follow-up of 1.9 years [6]. That trial's results accelerated guideline adoption of rosuvastatin for primary prevention, and telehealth now makes initiating that therapy accessible to patients across all ten New Hampshire counties.

How Rosuvastatin Compares to Other Statins on Cost

Rosuvastatin and atorvastatin are the two high-intensity statins recommended by current guidelines. Both are available as generics. In New Hampshire, their cash prices are similar: roughly $10 to $18 per month for a 30-day supply.

The choice between them is clinical, not financial. Rosuvastatin produces greater LDL reduction at equivalent milligram doses. A 2010 meta-analysis published in the American Journal of Cardiology found rosuvastatin 10 mg reduced LDL-C by approximately 46%, compared to 36% for atorvastatin 10 mg [7]. At maximum doses, rosuvastatin 40 mg lowers LDL by roughly 55%, while atorvastatin 80 mg achieves about 50%.

Dr. Paul Ridker, who led the JUPITER trial at Brigham and Women's Hospital, stated: "Rosuvastatin demonstrated consistent cardiovascular benefit in a population that would not have qualified for statin therapy under prior guidelines, fundamentally changing how we think about primary prevention."

Simvastatin and pravastatin, older moderate-intensity statins, are also generic and cheap ($4 to $12 per month in NH), but they cannot achieve the same degree of LDL lowering. For patients needing a 50% or greater reduction in LDL, rosuvastatin or atorvastatin are the only single-agent options.

Pitavastatin (brand Livalo, generic available since 2023) is a newer option with a favorable metabolic profile, but its generic price remains $30 to $60 per month in New Hampshire, making it two to four times more expensive than rosuvastatin or atorvastatin for similar LDL reductions.

Practical Steps to Get the Lowest Price in New Hampshire

Start with the generic. Ninety percent of the savings opportunity is captured by simply filling generic rosuvastatin instead of brand Crestor. That single switch drops the monthly cost from $290 to $15.

Beyond that baseline, consider these options:

Use a discount card. GoodRx, RxSaver, and SingleCare coupons are accepted at all major New Hampshire chains and can push generic rosuvastatin below $8 per month at select pharmacies in the state.

Ask about 90-day fills. Mail-order and retail 90-day prescriptions typically reduce the per-day cost by 10% to 20%. For a medication taken daily and indefinitely, this adds up. A 90-day fill of rosuvastatin 20 mg runs $25 to $40 at most NH pharmacies.

Check your plan's preferred pharmacy. Some insurers offer $0 copay generic tiers when you use a preferred pharmacy network. In New Hampshire, Walmart, Costco, and select independents participate in these networks.

Explore patient assistance. For uninsured patients, many generic manufacturers offer patient assistance programs (PAPs) that provide rosuvastatin at no cost for qualifying individuals. NeedyMeds and RxAssist maintain updated directories.

A 2022 study in Circulation found that out-of-pocket costs exceeding $10 per month were associated with a 10% to 15% decrease in statin adherence over 12 months [8]. New Hampshire's sub-$15 generic pricing places rosuvastatin well within the adherence-friendly range for most patients.

Safety Monitoring and What Your Prescriber Should Order

Rosuvastatin is generally well-tolerated, but monitoring is not optional. Before starting therapy, your prescriber should obtain a fasting lipid panel and hepatic transaminases (ALT, AST). The FDA label for rosuvastatin recommends checking liver function tests prior to initiation and "when clinically indicated thereafter" [1].

Myalgia (muscle pain) is reported by 2% to 11% of patients across clinical trials, though nocebo-controlled studies suggest the true drug-attributable rate is closer to 1% to 2%. The SAMSON trial (N=60) published in the New England Journal of Medicine in 2020 demonstrated that approximately 90% of statin-attributed muscle symptoms were replicated by placebo [9].

For patients at higher risk of myopathy (concomitant use of cyclosporine, gemfibrozil, or certain protease inhibitors), the maximum recommended rosuvastatin dose is 5 mg daily. Asian patients may also have higher rosuvastatin exposure due to pharmacogenomic differences, and the FDA recommends starting at 5 mg in this population.

Dr. Steven Nissen of the Cleveland Clinic has noted: "The muscle side effects attributed to statins are dramatically overestimated in public perception. When patients understand the data, most are willing to continue therapy."

Follow-up lipid panels should be drawn 4 to 12 weeks after initiation or dose change. If the patient achieves their LDL target (typically <70 mg/dL for high-risk or <100 mg/dL for moderate-risk), annual monitoring suffices. Renal function (eGFR) should be assessed periodically, as rosuvastatin is contraindicated at doses above 10 mg in patients with severe renal impairment (GFR <30 mL/min).

Who Should Be on Rosuvastatin in New Hampshire

The 2018 ACC/AHA guideline identifies four statin benefit groups: patients with clinical ASCVD, patients with LDL ≥190 mg/dL, diabetics aged 40 to 75, and patients with a 10-year ASCVD risk ≥7.5% [4]. For the first two groups, high-intensity statin therapy (rosuvastatin 20 to 40 mg) is the standard of care.

New Hampshire's cardiovascular disease burden is moderate compared to the national average, but heart disease remains the second leading cause of death in the state, behind cancer. The CDC reports that approximately 160 per 100,000 New Hampshire residents die from heart disease annually [10]. Statin therapy is one of the most evidence-supported interventions to reduce that number.

JUPITER enrolled participants with median baseline LDL of 108 mg/dL, well below traditional treatment thresholds. The trial was stopped early because the rosuvastatin group showed a 20% reduction in all-cause mortality (P=0.02) [6]. For New Hampshire residents whose prescribers identify them as candidates for primary prevention, the combination of low-cost generic rosuvastatin and statewide telehealth access removes the most common barriers to initiation.

Patients filling rosuvastatin 20 mg daily at a New Hampshire pharmacy in 2026 can expect to pay roughly $15 per month without insurance, under $10 with most commercial plans, and $1 to $3 with Medicaid.