University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA.
University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH, USA.
J Sex Med. 2018 Dec;15(12):1785-1791. doi: 10.1016/j.jsxm.2018.10.011.
Variability in prices of medications is a well-known phenomenon; however, this variability has not been quantified in the realm of erectile dysfunction (ED) medications. ED medications are ideal for this quantification, because they are often not covered by insurances; therefore, the cost is the most direct reflection of price variability among pharmacies as they affect the patients.
To evaluate the variability in cash prices for phosphodiesterase type 5 inhibitors (PDEIs) for ED. We also evaluated whether certain types of pharmacies consistently offer better pricing than others, and whether there was any correlation with demographic factors.
331 pharmacies were contacted within a 25-mile radius of our institution to obtain the cash price for 4 commonly used ED medications with prespecified doses. After exclusion, 323 pharmacies were categorized as chain, independent, wholesale, or hospital-associated. Cash prices for the specified medications were evaluated. In addition, we identified demographic and socioeconomic factors to determine if these had an impact on median drug pricing within each zip code.
The main outcome was the cost for patients to fill each prescription.
Independent pharmacies provided the lowest cost for 3 of 4 of the PDEIs. The largest price difference for 10 tablets of 100 mg sildenafil between all pharmacies was 38,000%. The median cost difference between independent pharmacies and chain pharmacies for sildenafil was >900%, and >1,100% for independent pharmacies vs hospital-associated pharmacies. Demographic and socioeconomic factors had no impact on the cost.
Our goal is to promote patient counseling among practitioners and to empower patients to shop for the best prices for their medications.
A strength of the study is the large cohort that was surveyed; however, a weakness is that the large majority of the cohort was comprised of chain pharmacies. Mail pharmacies could not be evaluated as they required a valid prescription before offering prices.
The drastic differences in cash prices for the PDEIs give us an insight into the variability and cost-inflation of medications in the United States. These patterns hold true for other essential medications as well, and improved transparency will allow patients to make informed decisions when choosing where to purchase their medications. It may also encourage certain pharmacies to provide medications at more affordable prices. Mishra K, Bukavina L, Mahran A, et al. Variability in prices for erectile dysfunction medications-Are all pharmacies the same? J Sex Med 2018;15:1785-1791.
药物价格的差异是一个众所周知的现象；然而，这种差异在勃起功能障碍（ED）药物领域尚未量化。ED 药物非常适合这种量化，因为它们通常不在保险范围内；因此，成本是药店之间价格差异的最直接反映，因为这会影响患者。
评估磷酸二酯酶 5 抑制剂（PDEIs）治疗 ED 的现金价格差异。我们还评估了某些类型的药店是否始终提供更好的定价，以及是否与人口统计学因素有关。
在我们机构 25 英里半径范围内联系了 331 家药店，以获取 4 种常用 ED 药物的指定剂量的现金价格。排除后，将 323 家药店分为连锁店、独立药店、批发商或医院相关药店。评估指定药物的现金价格。此外，我们确定了人口统计学和社会经济因素，以确定这些因素是否会影响每个邮政编码内的药物定价中位数。
主要结果是每位患者填写每张处方的费用。
4 种 PDEIs 中的 3 种，独立药店的价格最低。所有药店中 10 片 100mg 西地那非的最大价格差异为 38,000%。西地那非独立药店与连锁店药店之间的中位成本差异超过 900%，独立药店与医院相关药店之间的中位成本差异超过 1,100%。人口统计学和社会经济因素对成本没有影响。
我们的目标是促进从业者对患者进行咨询，并使患者能够为他们的药物购买最好的价格。
研究的一个优势是调查了大量的队列；然而，一个弱点是，大部分队列都是连锁店药店。由于在提供价格之前需要有效的处方，因此无法评估邮购药店。
PDEIs 的现金价格差异之大，让我们了解了美国药物的可变性和成本膨胀。这些模式也适用于其他基本药物，提高透明度将使患者在选择购买药物的地点时能够做出明智的决定。它还可能鼓励某些药店以更实惠的价格提供药物。Mishra K、Bukavina L、Mahran A 等人。勃起功能障碍药物价格的差异-所有的药店都一样吗？J 性医学 2018；15:1785-1791。
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