Comparison of Discounted and Undiscounted Cash Prices for Cardiovascular Medications by Type of US Community Pharmacy
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BACKGROUND: Cash prices for prescription drugs vary among community pharmacies in the USA. GoodRx is a discount platform that provides coupons for use in community pharmacies without a membership requirement. Analytical pharmacy is a new type of pharmacy that tests drugs before dispensing to verify medication quality. OBJECTIVE: To compare undiscounted and GoodRxdiscounted cash prices for common cardiovascular (CV) drugs by pharmacy type. DESIGN: A cross-sectional study. SETTING: GoodRx-discounted and GoodRxundiscounted cash price data; analytical pharmacy cash price data (all data collected in July 2020). MEASUREMENTS: GoodRx cash price data for 30 units of 41 generic and 16 brand-name common cardiovascular medications at mass merchandiser, regional supermarket, two national chains, and analytical pharmacy (only one of its kind in the USA). RESULTS: The average (SD) undiscounted generic CV medication cash price was $42.41 (44.1). The average GoodRx-discounted generic CV medication cash prices were $11.01 (8.6), $9.88 (6.7), $17.85 (10.5), and $21.73 (14.1) in mass merchandiser, supermarket, and two national chain pharmacies, respectively. The average generic CV medication cash price was $20.84 (25.7) at the analytical pharmacy. The average (SD) undiscounted brandname CV medication cash price was $368.33 (127.00). The average GoodRx-discounted brand-name CV medication cash prices were $269.16 (118.1), $258.84 (108.6), $270.28 (118.4), and $274.60 (122.50) for mass merchandiser, supermarket, and two national chain pharmacies, respectively. The average (SD) brand-name CV medication cash price was $365.12 (116.20) at the analytical pharmacy. CONCLUSIONS: GoodRx-discounted cash prices of generic CV medications were significantly lower than undiscounted cash prices at supermarket, mass merchandiser, and national chain pharmacies. Analytical pharmacy cash prices too were significantly lower than traditional pharmacy undiscounted cash prices. GoodRx-discounted prices for brand-name CV medications did not differ significantly from undiscounted cash prices and between pharmacy types.
KEY WORDS: drug prices; discount programs; community pharmacy; analytical pharmacy; cash prices. J Gen Intern Med DOI: 10.1007/s11606-020-06149-7 © Society of General Internal Medicine 2020
INTRODUCTION
Fifty percent of all Americans take prescription drugs for managing chronic diseases and nearly 70% of adults aged between 40–79 years use at least one at any given month.1, 2 Medication non-adherence due to cost is common, especially among patients with a high cost-sharing plan or no insurance at all. 3–6 These patients often pay out-of-pocket for prescription medications, with prices varying as much as several folds depending on the type of pharmacy.7, 8 A patient may lower out-of-pocket cost by using a discount coupon offered by companies such as GoodRx and by choosing the pharmacy that offers the best price based on estimates from the company’s website or mobile app. A patient without Internet access may obtain a paper coupon from a healt
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