To examine the geographic and pharmacy-type variation in costs for generic benign prostatic hyperplasia (BPH) medications in order to improve drug price transparency and reduce health disparities. Medical therapy for BPH can be expensive, having significant implications for uninsured and underinsured patients.
We generated a 20% random sample of all pharmacies in Pennsylvania and queried each for the uninsured cash price of a 30-day prescription of tamsulosin 0.4mg daily, finasteride 5mg daily, oxybutynin immediate release 5mg TID and oxybutynin XL 10mg daily. Our primary objectives were to identify price variation based on pharmacy type (i.e., big chain and independent) and between geographic regions (predetermined by the Pennsylvania Health Care Cost Containment Council Database). We fit multivariable quantile regression models to test for an association between drug price and region after controlling for pharmacy type.
Among 575 retail pharmacies contacted, 473 responded (82% response rate). The median cash price was significantly higher for big chain pharmacies than for independent pharmacies for tamsulosin ($66 vs. $15), finasteride ($68 vs. $15), oxybutynin immediate release ($49 vs. $35), and oxybutynin XL ($79 vs. $31) (all p < 0.05). When controlling for region, the median and 75th percentile price of all drugs was significantly higher for big chain pharmacies. When controlling for pharmacy type, regional variation was noted in all four drugs at the 75th percentile price and was greater for independent pharmacies.
Compared to independent pharmacies, big chain pharmacies charged significantly more for generic BPH medications to uninsured patients. However, independent pharmacies demonstrated more regional variation in their pricing.
Urology. 2020 Sep 19 [Epub ahead of print]
Anup A Shah, Praveen Kumar, Ayodele G Ogunmola, Omar Ayyash, Jonathan G Yabes, Lindsay M Sabik, Anobel Y Odisho, Jathin Bandari, Liam C Macleod, Benjamin J Davies, Bruce L Jacobs
Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: ., Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Electronic address: ., University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: ., Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: ., Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Electronic address: ., Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Electronic address: ., Department of Urology, School of Medicine, University of California, San Francisco, CA. Electronic address: ., Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: ., Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: ., Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: ., Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: .