Variation in Prescription Drug Prices by Retail Pharmacy Type A National Cross-sectional Study
Variation in Prescription Drug Prices by Retail Pharmacy Type A National Cross-sectional Study
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DOI：
10.7326/m18-1138
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发表时间：
2019-11-05
影响因子：
39.2
通讯作者：
Kesselheim, Aaron S.
中科院分区：
文献类型：
--
作者：
Luo, Jing;Kulldorff, Martin;Kesselheim, Aaron S.
背景资料：处方药的现金价格在美国差异很大。目的：描述现金价格变化的零售药店类型为10个通用名和6个品牌的药物在整个美国和分层的邮政编码。设计：横断面研究。设置：来自GoodRx的药品定价数据，GoodRx是一种用于比较药品价格的在线工具，代表了60，000多家美国药店（2015年秋季）。测量：确定了1个月供应的仿制药和品牌药的现金价格。按邮政编码分层，与大型连锁药店的参考组相比，估计了大型、杂货店、小型连锁和独立药店的仿制药和品牌药组的相对现金价格。结果：在16 325个邮政编码中，68 353家独特的药店贡献了现金价格。当按5位数邮政编码分层时，与大型连锁药店相比，大型连锁药店，杂货店，小型连锁药店和独立药店的仿制药相对现金价格为0.52（95% CI，0.51至0.53）、0.82（CI，0.81至0.83）、1.51（CI，1.45至1.56）和1.61（CI，1.58至1.64）。品牌药的相对现金价格为0.97（CI，0.96至0.97），1.00（置信区间，0.99至1.00），1.06（CI，1.05至1.08）和1.03（CI，1.02 - 1.04）。局限性：结果可能不反映当前的药品价格，也不考虑销售点折扣或小型药店可能提供的价格匹配。与大型连锁店相比，独立药店和小型连锁店的仿制药现金价格最高，大型药店最低。不同类型的零售药店，品牌药品的现金价格相对差异不大。
Background: Cash prices for prescription drugs vary widely in the United States.Objective: To describe cash price variation by retail pharmacy type for 10 generic and 6 brand-name drugs throughout the United States and stratified by ZIP code.Design: Cross-sectional study.Setting: Drug pricing data from GoodRx, an online tool for comparing drug prices, representing more than 60 000 U.S. pharmacies (fall 2015).Measurements: Cash prices for a 1-month supply of generic and brand-name drugs were ascertained. Stratified by ZIP code, relative cash prices for groups of generic and brand-name drugs were estimated for big box, grocery-based, small chain, and independent pharmacies compared with a reference group of large chain pharmacies.Results: Across 16 325 ZIP codes, 68 353 unique pharmacy stores contributed cash prices. When stratified by 5-digit ZIP code, the relative cash prices for generic drugs at big box, grocery-based, small chain, and independent pharmacies compared with those at large chain pharmacies were 0.52 (95% CI, 0.51 to 0.53), 0.82 (CI, 0.81 to 0.83), 1.51 (CI, 1.45 to 1.56), and 1.61 (CI, 1.58 to 1.64), respectively. The relative cash prices for brandname drugs were 0.97 (CI, 0.96 to 0.97), 1.00 (CI, 0.99 to 1.00), 1.06 (CI, 1.05 to 1.08), and 1.03 (CI, 1.02 to 1.04), respectively.Limitation: Results may not reflect current drug prices and do not account for point-of-sale discounts or price matching that may be offered by smaller pharmacies.Conclusion: Compared with large chains, independent pharmacies and small chains had the highest cash prices for generic drugs and big box pharmacies the lowest. Relative differences in cash prices for brand-name drugs were modest across types of retail pharmacies.