Purpose
Generic medications are considered a cost efficient alternative for medical management of glaucoma. Prescribers may not be aware of the variability among prices of generic medications. Through a prospective, observational study, we hypothesize a significant cost difference among common generic glaucoma medications across various national pharmacy chains.
Methods
Data was collected from 5 national pharmacy chains (pharmacy A,B,C,D,E) after comprehensive inquiries were made over telephone and web data mining. Most commonly used generic medications were chosen: 1) Latanoprost, 2) Timolol, 3) Dorzolamide, 4) Timolol /dorzolamide fixed combimnation, 5) Brimonidine 0.15% and 6) Brimonidine 0.2%. Cash “out of pocket” prices were collected. Means, standard deviation, and range were calculated. ANOVA & Student T-Test were performed for comparisons.
Results
Range, mean, and standard deviation (SD) for the prices of 6 generic medications across 5 national pharmacy chains are shown in table 1. We found that the range of mean prices for the 6 generic medications ranged from $9.80 (Timolol) to $96.95 (Brimonidine 0.15%). Analysis of variance comparing the mean prices of medications showed statistical significance (P-value 1.45E-05). Mean cost of 6 generic medications was calculated for each pharmacy which ranged from $28.30 to $65.06. The cash cost difference between pharmacy with the lowest (D) and highest (B) mean prices was statistically significant (p=0.02). Latanoprost had the highest cost variability with a % difference of 464% between the cheapest and most expensive pharmacy chain. The medication with lowest variability was Brimonidine 0.15%, however across all pharmacies this medication was among the most expensive options. Timolol 0.5% had the lowest cost and exhibited the least price variation.
Conclusions
When comparing generic topical glaucoma medication costs, we found statistically significant differences in prices. While generic medications can be a cost efficient method to treating glaucoma, out of pocket expense varied widely among 5 national pharmacy chains. Latanoprost had the greatest percent difference of 464%, between the lowest and highest prices with 5/6 medications exhibiting large % differences in prices that exceed 200%. Based on this analysis, prescribers should be aware of wide variations among generic medications costs which can influence affordability to patients.