[jyl]

Not sure what the ACA has to do with drug pricing or hospitals losing money.

Sildenafil is a generic and as such, a fairly inexpensive drug. Any theory why the grocery store pharmacy was trying to charge so much?

One possibility for what actually happened is the prescription could have been written for the brand drug, Revatio, which is a dosage of sildenafil intended specifically for pulmonary hypertension (PAH). PAH is a very serious and fairly rare disease, the drugs for it tend to be high priced, and if someone actually buys the branded Revatio instead of the generic sidenafil, they will pay a high price. The generic was only approved in March 2016, so possibly the doctor wrote the prescription for Revatio and/or the grocery store pharmacy only had the branded Revatio.