D., BCPSClinical pharmacy specialist, Providence Health Plan Doxycycline has been on the market for several years, but it's been in more demand recently as tetracycline has become less available. This demand, coupled with a lack of raw materials for doxycycline and discontinued production by a few manufacturers such as Teva, has caused price volatility in the market. The hyclate salt form of doxycycline historically has been less expensive, but recently the monohydrate version has become cheaper. Both doxycycline hyclate and monohydrate are equally effective. However, the different salt forms and dosing recommendations can cause confusion for providers and pharmacists. Please be aware that switching between products does require provider approval. Because of increased out-of-pocket costs for patients and the total cost of care in general, consider choosing the less expensive product when prescribing doxycycline. Geoffrey Joyce does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment. More than eight out of every 10 prescriptions dispensed in the US is generic. This growth is due to a large number of top-selling drugs going off patent over the past decade, as well as innovations in the retail sector, such as Walmart’s US$4 generic program. Over this period, generic drug prices declined or held steady, saving American consumers tens of billions of dollars annually. But recently prices of some long-time generic drugs like digoxin (a heart medication), albuterol (for asthma) and doxycycline (an antibiotic) increased more than ten-fold over a very short period of time. This has prompted the Senate subcommittee on health and aging to investigate why prices for some generic drugs have risen so high, so fast. 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