Abstract 20327: Variability in Pricing of Generic Drugs for Heart Failure: Caveat Emptor
Introduction: The advent of generic medications for CHF lessened the financial burden on uninsured and underinsured patients; however, recent controversies about pricing have raised concern about increased out-of-pocket costs and consequent lower adherence. Therefore, we evaluated retail pharmacy pricing in a 2-state region to assess variability in pricing for three generic CHF drugs (digoxin-Dig, lisinopril-Lis and carvedilol-Carv) as a function of dose, supply (30 vs 90-day), pharmacy type (chain vs. independent), pharmacy zip code and zip code median income.
Methods: In a telephone survey of retail pharmacies across 55 zip codes, we collected data on pricing for two doses of Dig (0.125/0.25mg), Lis (10/40mg), and Carv(6.25/25mg2) for 30 and 90-day prescriptions. US Census Bureau data were used to obtain median income by zip code. Mann-Whitney mean rank tests, non-parametric correlations, and cluster analyses were used to analyze data.
Results: A total of 175 pharmacies (153 chain) provided pricing data. Median income of pharmacy zip codes was $53122 (range $10,491-112,017). The number of generic manufacturers varied by drug (Dig-7, Lis-9, Carv-8). The range of pricing was significant (Table); for example, the combined cost of low dose Dig+Lis+Carv varied from $20.19 to $256.77 (median $67.98) and high dose from $12.00 to $397.58 (median $70.68). Dig was consistently the most expensive. Variability in pricing was not a function of pharmacy type, zip code, region or median income. Only 1 of 3 major chains had consistent pricing across all its retail stores.
Conclusions: For patients without pharmacy coverage, wide variability was seen in the pricing of common generic drugs used to treat CHF, based on the pricing practices of individual retail pharmacies, unrelated to drug dose, duration of therapy, pharmacy type or location. Implications for adherence may be greatest in low income areas, where patients may not have convenient access to lower-priced pharmacies.
Author Disclosures: Z.D. Goff: None. A. Vidic: None. J.T. Chibnall: None. B. Bleske: None. P.J. Hauptman: None.
- © 2016 by American Heart Association, Inc.