Theisen Katherine M, Park Seo Young, Jeong Kwonho, Macleod Liam C, Bandari Jathin, Ayyash Omar, Odisho Anobel Y, Jacobs Bruce L, Davies Benjamin J
University of Pittsburgh Medical Center, Pittsburgh PA.
University of Pittsburgh School of Medicine, Pittsburgh PA.
Urology. 2019 Feb;124:223-228. doi: 10.1016/j.urology.2018.10.020. Epub 2018 Oct 23.
To characterize geographic variability of generic benign prostatic hyperplasia (BPH) medications in order to improve drug price transparency and improve patient access to affordable medication sources. This is of interest because BPH is one of the most common chronic diseases in men and contributes to individual healthcare cost. Medical therapy is the main treatment modality for BPH, burdening patients with lifelong medication expenses which may impact adherence and subsequent outcomes. With an aging population, this is compounded by many older individuals requiring multiple daily medications.
All pharmacies within a 25-mile radius of our institution were identified and classified as chain, wholesale or independent. The out-of-pocket price for a 30-day supply of tamsulosin (0.4 mg), finasteride (5 mg), oxybutynin (5 mg TID), and oxybutynin 10 mg XL were obtained using a scripted telephone survey. Multivariable linear regression assessed the association between census-tract level demographic and socioeconomic factors and disparate generic out-of-pocket drug-pricing.
The response rate was 93% with 255 pharmacies across 173 census tracts providing data. By pharmacy type, there was up to 5.5-fold variation in median out-of-pocket drug prices for the most common BPH medications. Demographic and socioeconomic factors were not significantly associated with generic BPH drug price variation.
The out-of-pocket price of generic medications for BPH varies significantly between pharmacies in a geographically-confined area. This study highlights the need for quality improvement initiatives that empower patients to price-compare and improve drug price transparency.
描述良性前列腺增生（BPH）常用药物的地域差异，以提高药品价格透明度，改善患者获得平价药物来源的机会。这一点很重要，因为BPH是男性最常见的慢性病之一，会增加个人医疗成本。药物治疗是BPH的主要治疗方式，患者需承担终身药物费用，这可能会影响依从性及后续治疗效果。随着人口老龄化，许多老年人需要每日服用多种药物，这使情况更加复杂。
确定我们机构半径25英里范围内的所有药店，并将其分类为连锁药店、批发药店或独立药店。通过电话脚本调查获取坦索罗辛（0.4毫克）、非那雄胺（5毫克）、奥昔布宁（5毫克，每日三次）和奥昔布宁10毫克长效制剂30天用量的自付费用。多变量线性回归评估了人口普查区层面的人口统计学和社会经济因素与不同的非专利药自付药价之间的关联。
回复率为93%，来自173个人口普查区的255家药店提供了数据。按药店类型划分，最常用的BPH药物的自付药价中位数相差高达5.5倍。人口统计学和社会经济因素与非专利BPH药物价格差异无显著关联。
在一个地理区域内，各药店之间BPH非专利药的自付费用差异显著。本研究强调了开展质量改进举措的必要性，这些举措应使患者有能力进行价格比较并提高药品价格透明度。
