Finding the Lowest-Cost Pharmacy for Cancer Supportive Care Medications: Not So Easy

Abstract

PURPOSE: To decrease the financial burden on people with cancer, clinicians and patients increasingly use medication price comparison websites to seek pharmacies where medications may be cheaper. Shopping around at different pharmacies can add additional time and logistic burden to patients and care partners. We sought to determine whether a single pharmacy consistently offered the lowest price for symptom control medications. METHODS: We compiled medications/formulations used to manage two common cancer-associated symptoms: nausea/vomiting and anorexia/cachexia. We extracted discounted, lowest price with coupon prices for a typical fill of these medications at nine pharmacies in Minneapolis, MN, using GoodRx. We compared prices across formulations and pharmacies to assess whether a pharmacy consistently offered the lowest price. RESULTS: We included 24 formulations for nausea/vomiting (14 generic and 10 brand-name) and 19 for anorexia/cachexia (12 generic and seven brand-name). Prices for brand-name formulations were similar across pharmacies, but prices of generic formulations varied widely across pharmacies. For example, the prices of a seven-unit fill of generic 5-mg olanzapine tablets ranged from $4 to $57 US dollars. No single pharmacy consistently offered the lowest price across the formulations studied. For example, for the 12 generic formulations for anorexia/cachexia, one pharmacy had the highest price for four formulations and the lowest price for two others. CONCLUSION: In this study of discounted medication prices, we found that no single pharmacy in an urban zip code consistently offered the lowest price for medications used to manage two common cancer-associated symptoms. Well-intentioned efforts to pursue the cheapest source of each medication by visiting multiple pharmacies may add extra time and logistic toxicity to patients and care partners. This approach can increase redundant scripts and expose patients to medication-related adverse events.

Health Care Contact Days Experienced by Decedents With Advanced GI Cancer

“…We also did not include the time spent in other home-based care, such as telephone visits, virtual appointments, or of activities, such as picking up medications at private pharmacies, not captured in the electronic medical record. 16,17 The primary source of contact days was frequent outpatient visits-these may in fact be more burdensome to patients and care partners since they impose daily travel and logistic burdens, in addition to psychological reminders to patients about their sickness. 18,19 The median survival of the cohort, approximately 6 months, is similar to the other real-world studies and lower than what is reported in contemporary clinical trials.…”

Association Between Prescription Drug Discount Cards and Out-of-Pocket Costs for HFrEF Regimens

“…Our study confirms that it is beneficial for patients to comparison price shop. In an analysis of medications prescribed for nausea/vomiting and cachexia/anorexia associated with cancer, Etteldorf et al 22 evaluated prices using GoodRx discount cards at 9 Minneapolis retail pharmacies and found that no single pharmacy consistently offered the lowest price across different formulations. Hauptman et al 9 previously established that, in the absence of discount cards, generic drugs for HF show wide variability in pricing among retail pharmacies in a 2-state Midwest region.…”

Complex Picture of Prescription Drug Discount Programs and Out-of-Pocket Costs in Cardiovascular Disease

“…Finally, most of these programs solve problems for uninsured patients but create complications for insured patients with high out-of-pocket costs who try to balance the best ways to obtain medications and may end up creating even more piecemeal ways for how they obtain care. 10 Further, many, if not all of these coupon programs still cannot be used at the same time as insurance, so even if patients are able to receive a lower-priced medication through the program, it would not contribute to their annual insurance deductible.…”