DrugDashboards

Bismuth Subcitrate Potassium, Metronidazole and Tetracycline Hydrochloride

Bismuth Subcitrate Potassium, Metronidazole and Tetracycline Hydrochloride · BISMUTH SUBCITRATE POTASSIUM 140 mg/1; METRONIDAZOLE 125 mg/1; TETRACYCLINE HYDROCHLORIDE 125 mg/1 · Capsule · Oral · Par Health USA, LLC

NDC 49884-0151-54 · 120 CAPSULE in 1 CARTON · ANDA · View full market →

The short version

Just 2 companies supply this market — thin enough that a single exit would be felt immediately. The price has fallen 41% in a year, to $2.38 per unit — and generics that get this cheap tend to get abandoned rather than defended. Put together: worth watching — several of the pressures that precede supply trouble are present at once.

The numbers behind every sentence are on this page below — and the Watch button emails you when any of them move.

One drug, every price

The same NDC has different prices depending on who is paying. Units differ between rungs — compare within a rung over time, not rung against rung, unless the units match.

ⓘ How this was built
Data sources
  • CMS NADAC (pharmacy acquisition, weekly)
  • CMS Part B ASP quarterly payment limits
  • CMS Maximum Fair Prices (IRA negotiated, NDC-level)
  • Medicare Part D Spending by Drug (data.cms.gov, name-matched)
  • VA FSS / Big4 federal contract prices (va.gov, twice monthly)
  • ACA Federal Upper Limits + weighted AMP (data.medicaid.gov, monthly)
  • California SB-17 WAC filings (list price, per package)
Method

Each rung is the newest figure for this NDC from one federal price system, shown with its own unit. Part D is matched by drug name because CMS publishes no NDCs there; it is gross spending, before confidential rebates.

Pipeline and calculations built by Claude (Fable 5) from the public datasets above. Educational only — verify against primary sources before acting.

  • Pharmacies pay (NADAC)$2.38per EAinvoice-surveyed acquisition cost · Aug 19, 2026
  • Part D point of sale (median)$5.15per unitnegotiated price across 220 plans — before rebates · Apr 1, 2026
  • Medicaid generic ceiling (FUL)$2.68per CAPweighted avg manufacturer price $1.5306 · Aug 1, 2026113% of what pharmacies pay — higher than 67% of drugs with this benchmark

Medicare Part D

All Part D pricing →
ⓘ How this was built
Data sources
  • CMS quarterly Prescription Drug Plan Formulary & Pricing files (SPUF)
Method

Negotiated 30-day point-of-sale unit prices and formulary terms aggregated across every unsuppressed Part D and MA-PD plan for the quarter shown. Point of sale means gross of confidential rebates. CMS publishes one representative NDC per drug concept (RxCUI) rather than every package, so these figures come from CMS's representative package for the same drug — matched on generic name, strength, and dosage form. Estimated from MedPAC's program-wide rebate aggregates (June 2023: DIR = 29% of gross Part D spending; brand rebates ≈ 25–40% of gross, generics minimal). Actual rebates are confidential and vary widely by drug — this is a range, not a fact about this drug.

Pipeline and calculations built by Claude (Fable 5) from the public datasets above. Educational only — verify against primary sources before acting.

Plans pay at point of sale
$5.15per unit
middle half $2.35$5.67 · 220 plans · Apr 1, 2026
Est. net of rebates
≈ $5.15
generic — rebates are minimal, so net ≈ gross
Coverage & restrictions
4%of plans cover it
tier 4 · prior auth 0% · step therapy 0% · qty limit 4%

*No drug-level rebate is public — the estimate applies MedPAC's program-wide brand rebate range to this drug's gross price. Tracked here for 10 quarters since 2024.

NADAC price per unit

$0$2.00$4.00$6.00Jan 2024Sep 2026$2.38
32 price points · per EA · dashed = manufacturer avg (WAMP)Source: CMS NADAC

Estimated fill cost

#30 count
$71.28
#90 count
$213.84

Estimates: latest NADAC unit price × quantity. Pharmacy acquisition cost only — excludes dispensing fees, markup, and insurance terms.

Medicaid spend (2025)

$1.1M
2,364 prescriptions paid by Medicaid nationally · all Medicaid spend →

Supply fragility

35Elevated risk

The score is counting real pressure here. One of these alone is routine; it’s the combination that makes this market worth watching.

  • 2 active manufacturers+20
  • price down 41% year over year+15

The score counts pressure that is already visible — fewer makers, shortages, recalls, falling prices. 0 means none of it; 100 means all of it at once. Recomputed daily · as of Sep 3, 2026

90-day shortage risk (model v2)

0.1%chance of a new FDA shortage posting for bismuth subcitrate potassium, metronidazole, and tetracycline hydrochloride (oral solid) in the next 90 days

sole-source market

For scale: the typical drug’s chance is about 0.1% — this one is in ordinary territory.

Backtested statistical model over the whole market, not this package alone. Model details →

Regulatory

Application
ANDA205770
TE code
AB
Approval date
Mar 6, 2023
Patents / exclusivity
None on file

Shortage history

No FDA shortage reports for this drug or its presentations.

Recalls (this NDC)

No enforcement reports list this package NDC.

Manufacturers of Bismuth Subcitrate Potassium, Metronidazole and Tetracycline Hydrochloride (Capsule)

LabelerStrengthFirst seenLast seen
H2-Pharma, LLCBISMUTH SUBCITRATE POTASSIUM 140 mg/1; METRONIDAZOLE 125 mg/1; TETRACYCLINE HYDROCHLORIDE 125 mg/1Jul 15, 2026Sep 2, 2026
Par Health USA, LLCBISMUTH SUBCITRATE POTASSIUM 140 mg/1; METRONIDAZOLE 125 mg/1; TETRACYCLINE HYDROCHLORIDE 125 mg/1Jul 15, 2026Sep 2, 2026

Roster from daily NDC Directory diffs — first/last seen dates start July 2026.

Cite this page

DrugDashboards, "Bismuth Subcitrate Potassium, Metronidazole and Tetracycline Hydrochloride — NDC 49884-0151-54," retrieved September 3, 2026, https://drugdashboards.com/drug/49884015154.

Free to cite with attribution — see how the data is put together.