Prescription Drugs Cost More in Poor Areas

Four of the most widely prescribed drugs in the United States can cost 15 percent more on average in the poorest neighborhoods of Florida, according to a study comparing retail pharmacy prices around the state.

Part of the explanation is the high proportion of independent pharmacies in poor ZIP codes that charge the highest prices for Nexium, Advair, Plavix and azithromycin, said Walid Gellad, lead study author and an assistant professor of medicine at the University of Pittsburgh.

In contrast, the study shows that chain pharmacies are less expensive and less likely to vary their prices based on ZIP code. However, they are also less common in poorer areas.

The authors noted that some independent pharmacies in poor neighborhoods did charge prices similar to chain pharmacies, but that issues such as health literacy, finances and transportation could limit consumers from shopping around.

The study appears in the latest online issue of the journal Health Services Research.

Even small price increases have negative consequences, and two earlier studies found that the cost of prescription drugs discourages uninsured and poor people from filling their prescriptions. As a result of not controlling their health, they spend more time in emergency rooms.

“Insuring the uninsured is a priority,” Gellad said. “However, uninsured people who pay retail prices for their medications and struggle with health care costs should not face higher prices because of where they live. Even though these variations are based on data from only one state, they deserve further investigation.”

Bruce Stuart is a professor at the University of Maryland School of Pharmacy. He said that “although the authors focus on retail drug prices, the study shows four times more pharmacies in wealthy ZIP codes than in poor ones. Expanding health insurance coverage will not address that problem.”

Health Services Research is the official journal of the AcademyHealth and is published by John Wiley & Sons, Inc. on behalf of the Health Research and Educational Trust. For information, contact Jennifer Shaw, HSR Business Manager at (312) 422-2646 or .(JavaScript must be enabled to view this email address). HSR is available online at http://www.blackwell-synergy.com/loi/hesr.

Gellad WF, et al. Variation in drug prices at pharmacies: are prices higher in poorer areas? Health Services Research online, 2008

Source: Health Behavior News Service