One-dollar medications: evaluating the true cost

Abstract

Introduction: Dollar stores offer access to medications. Reports of adulteration and violations of good manufacturing practice (GMP) of the medications sold at these stores raise concern. Additionally, medications may be used inappropriately for self-treatment, resulting in suboptimal care and safety concerns. Is the cost of one-dollar medications truly a cost saving for consumers? Methods: This was a cross-sectional evaluation of medications sold in dollar stores. Medications were reviewed from December 2018 through July 2021. Researchers evaluated price comparisons of medications sold in dollar stores in comparison to those sold in pharmacies, assessed the quantity of the medication products from the manufacturer that had committed violations of GMP, and conducted a qualitative analysis of the safety of the medications for self- treatment with respect to current guidelines. Mann-Whitney U price analysis was performed between dollar store products and generic pharmacy products. Results: The cost per unit of pain medication was significantly higher for purchases at dollar stores (Mdn = 0.045) in comparison to generic pain medications sold in pharmacies (Mdn = 0.030), W = 251.5, p = 0.013. There was no statistical difference in the costs of all other medications. The majority of the medications (59%) were from the manufacturer that had committed violations of GMP. Only second-line treatment options were available, providing suboptimal treatments and increased risks for adverse effects and poorer control of symptoms. Conclusion: Consumers are not attaining a cost benefit when purchasing dollar store medications. Medications sold in settings in which a healthcare professional is not accessible should be limited to acute use dosing in place of packaging for chronic use. Additionally, further research is needed to determine if the violations determined for medications sold at the dollar store have been remedied.

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