It ends up prescribed commonly in the US too, which may make some difference in the price depending on insurance, though from what I hear anectdotally unfortunately not often for OTC meds. Truthfully idk because we don't have time to memorize that additional, inconsistent, constantly-changing layer of bureaucracy on the US healthcare shit-sandwich. Safety-net hospitals usually have people whose whole job is to help with stuff like this though

Is paracetamol expensive in the USA? Over here it's about 30p for 16. You'd need to need about 550 tablets to make it worth getting on prescription. The advantage of the prescription here is that to get that many you'd have to make over 200 trips to the shop due to sales restrictions.