背景:直接面向消费者(DTC)的药房出售仿制药,通常价格比传统零售药店低;然而,不是所有的药物都有,价格各不相同。
目的:确定DTC药房仿制药的供应和费用。
方法:横断面研究。
方法:2023年4月和5月有五家国家DTC药房。
方法:在2020年MedicareD部分中,每个患者成本最高的100个仿制药(昂贵)和患者数量最高的50个仿制药(普通药)的每种合格表格主要措施:这些药物的可用性以及标准化药物强度和供应的最低DTC药房价格(例如,30粒),与GoodRx零售药房价格相比。
结果:在118种昂贵的通用剂型中,94(80%)在一个或多个DTC药房可用;在52个常见的通用剂型中,51(98%)可用(p<0.001)。在药房提供的88种昂贵的仿制药数量和强度相当,42(47%)在亚马逊的成本最低,23人(26%)在马克古巴成本加药物公司,13(14%)在健康仓库,Costco和12(13%);对于51种常见的通用配方,16家(31%)在Costco的成本最低,14(27%)在亚马逊,10(20%)在沃尔玛,6(12%)在健康仓库,和5(10%)在马克古巴成本加药物公司。对于具有可用GoodRx零售药房价格的77昂贵仿制药,DTC药房的成本节省中位数为231美元(95%CI,129-792美元)或76%(IQR,53-91%);对于51种常见仿制药,节省19美元(95%CI,10-34美元)或75%(IQR,67-83%)。
结论:许多最昂贵的仿制药在直接面向消费者的药房不可用。同时,更便宜,常用的仿制药广泛可用,但是药品价格因药房而异,储蓄不多,要求患者以最低的成本四处购物。
BACKGROUND: Direct-to-consumer (DTC) pharmacies sell generic prescription drugs, often at lower prices than traditional retail pharmacies; however, not all drugs are available, and prices vary.
OBJECTIVE: To determine the availability and cost of generic drugs at DTC pharmacies.
METHODS: Cross-sectional study.
METHODS: Five national DTC pharmacies in April and May 2023.
METHODS: Each qualifying form of 100 generic drugs with the highest cost-per-patient (expensive) and the 50 generic drugs with the highest number of patients (common) in Medicare Part D in 2020 MAIN MEASURES: Availability of these drugs and the lowest DTC pharmacy price for a standardized drug strength and supply (e.g., 30 pills), compared to GoodRx retail pharmacy prices.
RESULTS: Of the 118 expensive generic dosage forms, 94 (80%) were available at 1 or more DTC pharmacies; out of 52 common generic dosage forms, 51 (98%) were available (p < 0.001). Of the 88 expensive generics available in comparable quantities and strengths across pharmacies, 42 (47%) had the lowest cost at Amazon, 23 (26%) at Mark Cuban Cost Plus Drug Company, 13 (14%) at Health Warehouse, and 12 (13%) at Costco; for 51 common generic formulations, 16 (31%) had the lowest cost at Costco, 14 (27%) at Amazon, 10 (20%) at Walmart, 6 (12%) at Health Warehouse, and 5 (10%) at Mark Cuban Cost Plus Drug Company. For the 77 expensive generics with available GoodRx retail pharmacy prices, the median cost savings at DTC pharmacies were $231 (95% CI, $129-$792) or 76% (IQR, 53-91%); for 51 common generics, savings were $19 (95% CI, $10-$34) or 75% (IQR, 67-83%).
CONCLUSIONS: Many of the most expensive generic drugs are unavailable at direct-to-consumer pharmacies. Meanwhile, less expensive, commonly used generics are widely available, but drug prices vary by pharmacy and savings are modest, requiring patients to shop around for the lowest cost.