Dollars per Pound

Pillz and Missilz

The public pays for medicine and for missiles, and by the pound the two price lists make no sense together. A pound of Daraprim went from 2 Hellfire missiles to 108 in August 2015, when the price of a tablet rose from $13.50 to $750.00. A pound of Pomalyst at its list price costs more than a whole F-35A, and a pound of generic amoxicillin runs within $4 of a pound of Ford-class aircraft carrier. Every answer comes back in Hellfires, at $125,468 a missile.

Each card names one thing and what it sells for. Weigh out a pound of each in your head and pick the pound that costs more. A weapon is weighed whole. A pill is weighed by the drug in it, so a pound of a 5 mg tablet is 90,718 tablets.

Trainee deals 12 pairs with no clock. Auditor and Expert never stop dealing, and the avatar you pick is the clock: Pillz is a bottle that keeps filling with pills, Missilz is a Hellfire on its launch rail with a lit fuse, and every right call buys time while every wrong one costs it. After each call the clock stops and the answer stays on screen until the next deal comes up by itself, and at Auditor and Expert the Next button or the space bar brings it up sooner. At Expert three cards come at once, and the call is the pound that costs the most.

Pick a level

Your avatar for Auditor and Expert

The Levels

LevelCardsClockThe call
Trainee12 pairsNoneThe pound that costs more, ← or →
AuditorEndless, two at a timeThe avatar, filling or burning a little faster with every pairThe pound that costs more, ← or →
Expert SADHOT AuditorEndless, three at a timeThe avatar, speeding up fasterThe pound that costs the most, 1 2 or 3

All 51 prices in the game, 37 pills, 12 weapons, gold and silver, ranked from the most expensive pound to the cheapest. Each pound is shown as a number of US missiles. Of five missiles, the ladder uses the one that matches the price to within 10 percent in the fewest missiles: a pound of Pomalyst at list price is 42 Tomahawks, and a pound of Sovaldi is 9 Hellfires. A pound worth less than one missile is shown as a fraction of one, such as 1/2 Hellfire for gold. The scale is logarithmic, so each gray line marks a price ten times the line before it.

It gives away every answer in the game. It opens by itself when a game ends.

  • Pill
  • Same pill at the Medicare price
  • Weapon
  • Metal
  • Silver, $893
  • Gold, $61,513
  • One Hellfire, $125,468
  1. 1Pomalyst4 mg capsule, list price42 Tomahawks$109,587,917
  2. 2Pomalyst4 mg capsule, Medicare price17 Tomahawks$43,595,267
  3. 3Vraylar1.5 mg capsule, list price5 Tomahawks$13,869,847
  4. 4Daraprim25 mg tablet, after August 20155 Tomahawks$13,607,771
  5. 5Vraylar1.5 mg capsule, Medicare price3 Tomahawks$7,761,469
  6. 6Ibrance125 mg capsule, list price1 Tomahawk$2,761,711
  7. 7Ibrance125 mg capsule, Medicare price3 Stingers$1,360,086
  8. 8Xtandi80 mg tablet, list price4 Javelins$1,273,839
  9. 9Sovaldi400 mg tablet, launch price, December 20139 Hellfires$1,133,981
  10. 10Rybelsus14 mg tablet, list price2 Stingers$1,035,703
  11. 11Farxiga10 mg tablet, list price7 Hellfires$840,658
  12. 12Epclusatablet holding 500 mg of drug, list price6 Hellfires$807,394
  13. 13Eliquis5 mg tablet, list price6 Hellfires$787,739
  14. 14Xtandi80 mg tablet, Medicare price2 Javelins$661,867
  15. 15Imbruvica420 mg tablet, list price4 Hellfires$537,615
  16. 16Trintellix20 mg tablet, list price3 Hellfires$408,233
  17. 17Xarelto20 mg tablet, list price3 Hellfires$390,845
  18. 18Levothyroxine50 mcg generic tablet3 Hellfires$368,498
  19. 19Eliquis5 mg tablet, Medicare price1 Javelin$349,266
  20. 20Jardiance25 mg tablet, list price1 Javelin$346,545
  21. 21Imbruvica420 mg tablet, Medicare price1 Javelin$335,478
  22. 22Rybelsus14 mg tablet, Medicare price1 Javelin$295,915
  23. 23Farxiga10 mg tablet, Medicare price2 Hellfires$269,887
  24. 24Daraprim25 mg tablet, before August 20152 Hellfires$244,940
  25. 25Biktarvytablet holding 275 mg of drug, list price2 Hellfires$231,799
  26. 26Xarelto20 mg tablet, Medicare price1/2 Javelin$148,929
  27. 27Jardiance25 mg tablet, Medicare price1 Hellfire$119,144
  28. 28Januvia100 mg tablet, list price1/4 Javelin$79,681
  29. 29Goldspot price, 2 October 20261/2 Hellfire$61,513
  30. 30Entresto97/103 mg tablet, list price1/4 Maverick$23,738
  31. 31Januvia100 mg tablet, Medicare price1/6 Maverick$17,085
  32. 32Lorazepam1 mg generic tablet1/6 Maverick$16,338
  33. 33Stingershoulder-fired missile with its launcher, 34.7 lb1/7 Maverick$13,833
  34. 34Entresto97/103 mg tablet, Medicare price1/9 Maverick$11,151
  35. 35THAAD interceptormissile-defense interceptor, 1,459 lb1/12 Maverick$8,765
  36. 36Javelinanti-tank missile with its launch unit, 49.5 lb1/16 Maverick$6,402
  37. 37AMRAAMair-to-air missile, 358 lb1/24 Maverick$4,307
  38. 38JAGMair-to-ground missile, 115 lb1/30 Maverick$3,364
  39. 39F-35Afighter jet, 29,300 lb empty1/32 Maverick$3,140
  40. 40Sidewinderair-to-air missile, 186 lb1/36 Maverick$2,859
  41. 41SM-6ship-launched missile, about 3,300 lb1/40 Maverick$2,532
  42. 42JASSM-ERcruise missile, 2,251 lb1/74 Maverick$1,386
  43. 43Hellfireair-to-ground missile, about 100 lb1/81 Maverick$1,255
  44. 44Amlodipine5 mg generic tablet1/111 Maverick$918.07
  45. 45Silverspot price, 2 October 20261/114 Maverick$893.08
  46. 46Lisinopril10 mg generic tablet1/123 Maverick$830.98
  47. 47TomahawkBlock V cruise missile, 3,330 lb1/131 Maverick$778.32
  48. 48Bupropion XL150 mg generic tablet1/428 Maverick$238.05
  49. 49Amoxicillin500 mg generic capsule1/1,436 Maverick$71.01
  50. 50Ford-class carrieraircraft carrier, 224,000,000 lb fully loaded1/1,502 Maverick$67.90
  51. 51Metformin500 mg generic tablet1/7,991 Maverick$12.76

Hover over a row for the basis of its price. Pills are weighed by the labeled strength of the drug.

Readings

A pound of Daraprim went from 2 Hellfires to 108 in August 2015, when the price of a tablet rose from $13.50 to $750.00. A pound of Pomalyst at its list price costs more than a whole F-35A, 1.2 jets to the pound, and the Medicare negotiated price brings it down to 347 Hellfires. Generic levothyroxine sells for $0.04062 a tablet and still ranks above gold, because the tablet holds 50 micrograms of drug. A Hellfire costs 1.4 times its weight in silver, a Tomahawk costs less than its weight in silver, and a pound of amoxicillin runs within $4 of a pound of Ford-class aircraft carrier.

The game counts in Hellfires, the air-to-ground missile carried by Apache helicopters and Reaper drones. The Army bought 920 of them in fiscal year 2022 for $115,431,000, which is $125,468 a missile. Other budget lines price the missile anywhere from $60,027 to $215,938, so every count in the game can halve or double with the choice of line. A Hellfire weighs about 100 pounds, which makes a pound of Hellfire worth $1,255.

The ladder shows each pound in one of five US missiles, the Tomahawk, the Stinger, the Javelin, the Hellfire and the Maverick, choosing the one that matches the price to within 10 percent in the fewest missiles. A pound worth less than one missile is a fraction of one, such as 1/2 Hellfire. The first four carry the prices on their own rows of the ladder. The Maverick is the GAO's figure for the infrared Maverick, the family of the AGM-65D, at about $102,000 a missile in 1991 dollars, from its review of the Desert Storm air campaign. Gold was $4,218.01 a troy ounce and silver $61.24 on 2 October 2026. A pound holds 14.583 troy ounces, which puts gold at $61,513 a pound and silver at $893. One Hellfire buys 2 pounds of gold or 140 pounds of silver.

A weapon is weighed whole. A pill is weighed by the drug in it, the strength printed on the label, because the label gives no weight for the tablet itself. A pound of drug is 453,592 milligrams, so a pound of a 5 mg tablet is 90,718 tablets. The measure rewards small doses: the fewer milligrams in the pill, the more pills in the pound.

Brand list prices and Medicare negotiated prices are the 30-day figures in the two CMS negotiation fact sheets, divided by the number of pills in 30 days. The 2026 negotiated prices are in force and the 2027 prices take effect on 1 January 2027. Biktarvy, Epclusa and Trintellix use the list prices their makers published for January 2026, and Ibrance uses the price Pfizer disclosed for 21 capsules on 1 May 2024. Generic prices are the National Average Drug Acquisition Cost, the CMS survey of what pharmacies pay, effective 19 August 2026 and read from ndclist.com. Sovaldi and Daraprim are priced from the Senate Finance Committee and Senate Aging Committee reports. Weapon prices are budget dollars divided by quantity in the Pentagon procurement tables, and weights come from the Navy Fact File, CSIS Missile Threat and published specifications.

Six figures rest on thinner ground. CMS prints one price for a 30-day supply of Pomalyst, a capsule taken 21 days in 28, and the ladder counts 22.5 capsules, the reading that gives the lower price. Imbruvica is counted at 30 tablets. Vraylar is priced at the 1.5 mg starting dose, and at 3 mg its figure halves. The Stinger price is a 2022 contract figure, the F-35A price comes from press reports of the Lot 18 and 19 contract, and the Maverick price is the GAO's figure from 1991.

Record

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