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Key takeaways
Without insurance, generic fluorouracil can cost $363 for one 40 g tube.
Your healthcare professionals will have various forms of fluorouracil to choose from when selecting treatment, and which one they choose will affect the cost.
A SingleCare prescription discount card can significantly reduce the cost of fluorouracil products, and could potentially save you hundreds of dollars.
Fluorouracil, sometimes called 5-FU, is a prescription chemotherapy drug used in the treatment of many types of cancers. It is available both as an injection and a topical product. Without insurance, one 40 gm tube of fluorouracil 5% topical cream costs about $363. There is no over-the-counter alternative, but there are ways to save on the uninsured price of fluorouracil cream and injection and make it more affordable.
RELATED: What is fluorouracil?
How much does fluorouracil cost without insurance?
Your cost for fluorouracil may vary depending on your diagnosis, treatment regimen, length, and insurance coverage. For the topical form, fluorouracil typically used in the treatment of skin conditions such as basal cell carcinoma or actinic keratosis, your cost without insurance can be as much as $363 for one 40 g tube of the 5% cream. It is difficult to determine what your annual cost may be due to the variance in the amount used per site treated and the length of time of treatment.
If you are using the injectable formulation, there can be additional associated costs for an infusion setting or hospital, infusion supplies, and other adjunctive therapies. The injectable formulations of this antineoplastic antimetabolite are typically provided through a medical facility as part of a more comprehensive treatment plan dictated by your healthcare provider and are not typically accessed through a retail pharmacy by patients directly. The injectable form is used for many cancerous conditions, including breast cancer, colon cancer, and others.
Your ultimate fluorouracil cost will be affected by the dosage type and strength of the fluorouracil product you are prescribed. The topical cream is available in brand names and strengths of Carac 0.5%, Fluoroplex 1%, Tolak 4%, and Efudex 5%. There are generic formulations of Carac and Efudex, but Tolak and Fluoroplex remain brand-name only at this time. For comparison, one 40 gm tube of Tolak 4% is about $233, but a single 40 gm tube of generic Efudex 5% cream can be accessed for less than $39.
How much does brand-name fluorouracil cost?
Tolak is the branded product for fluorouracil 4% cream. Without insurance, it can cost around $233 for a single 40 g tube of cream. With SingleCare, you can save on brand-name products in addition to generic products. A free SingleCare savings card will lower the price of one, 40 g tube of Tolak 4% cream to $43. If you have insurance, your cost will vary based on plan, deductibles, and copay status. It is beneficial to compare your out-of-pocket responsibility to the SingleCare price to make sure you are paying the lowest possible price. The table below compares the prices of some fluorouracil products and their alternatives.
| Drug name | Price without insurance | SingleCare price | Savings options |
|---|---|---|---|
| Tolak (fluorouracil) | $233 per 1, 40 gm of 4% tube | $43 per 1, 40 gm of 4% tube of brand-name Tolak | See latest prices |
| Generic fluorouracil 5% cream | $363 per 1, 40 gm of 5% tube | $39 of 1, 40 gm of 5% tube of generic fluorouracil | See latest prices |
| Zyclara (imiquimod) | $1,528 per 1 box (28 packets), 3.75% cream | $516 per 1 box (28 packets), 3.75% brand-name Zyclara | See latest prices |
| Generic imiquimod 5% | $128 per 1 box (28 packets), 5% cream | $15 per 1 box (28 packets), 5% generic imiquimod cream | See latest prices |
| Opzelura (ruxolitinib) | $2,867 per 1, 60 g 1.5% cream | $2,025 per 1, 60 g 1.5% brand-name Opzelura cream | See latest prices |
| Klisyri (tirbanibulin) | $1,474 per 1 box (5 packets), 250 mg 1% ointment | $1,181 per 1 box (5 packets), 250 mg 1% brand-name Klisyri ointment | See latest prices |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see the latest drug prices.
Save up to 80% on Fluorouracil with SingleCare
Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.
Is fluorouracil covered by insurance?
Fluorouracil is typically covered by commercial or private insurance, Medicare, and Medicaid plans with an appropriate diagnosis of skin cancer. Many plans may prefer generic versions, or their formulary will state specifically which forms are covered. Coverage will vary based on your plan and factors such as out-of-pocket responsibilities, deductibles, and copays.
The injectable form is likely covered through your medical plan, not your drug plan, as a part of a more comprehensive treatment setting.
How to get fluorouracil covered by insurance
A diagnosis of basal cell carcinoma or actinic keratosis typically covers Fluorouracil. You may be asked to go through an additional authorization process to share the diagnosis with the insurance carrier. Fluorouracil is sometimes used off-label, or without an FDA-approved indication, for some types of warts that have not successfully resolved with other treatments. This may also require some additional information before your plan will cover it for this reason.
If your plan denies fluorouracil, check your formulary to see if another formulation, perhaps in a different strength or brand name, would be covered. Make sure your prescriber and pharmacist have documented the correct diagnosis. Your prescriber and pharmacist can recommend alternatives for prescription savings if your insurance will not cover fluorouracil.
How to get fluorouracil without insurance
Fluorouracil is an effective medication for the treatment of basal cell carcinoma and the pre-cancerous condition, actinic keratosis. If the cost of fluorouracil is not something you can afford, then finding a way to save money on your prescription is really important. The manufacturer of Tolak, Hill Dermaceuticals, Inc., may provide some financial assistance for those who qualify. Contact the manufacturer for more details. Fortunately, that isn’t the only way to potential savings, and you can start with a SingleCare discount card.
1. Use a free coupon from SingleCare
The lowest price with SingleCare for generic fluorouracil 5% cream is less than $40 for a 40 g tube, just over 10% of the average retail price of $363. Discounts will vary by participating pharmacy, so browse current savings prices on SingleCare’s fluorouracil page. Make sure to sign up with SingleCare’s free loyalty program to earn additional savings each time you use a SingleCare discount.
RELATED: Where can I use my SingleCare card?
2. Look for the lowest price
Another way to unlock savings is to compare pharmacy prices. By using the lowest cost pharmacy, you could save over $300 on your fluorouracil prescription.
3. Use a fluorouracil product that has a generic equivalent on the market
If your prescriber initially chooses a brand-name product with no generic equivalent, such as Tolak, ask them to change to a generic prescription to save on the cost of the treatment.
4. Ask the prescriber about fluorouracil alternatives that your insurance covers
Fluorouracil may not be on your insurance plan in the prescribed form, but depending on the condition you are treating, you may have some alternatives on your plan that offer a lower out-of-pocket cost. It is always best to be familiar with your insurance formulary when you have coverage.
- Fluorouracil topical, drugs.com (2025)
- Tolak, Hill Dermaceuticals, Inc. (2025)