Background: Prescription medications are a major driver of the cost of health care. High prescription prices have been associated with medication non-adherence, leading to frequent hospitalizations, readmission and uncontrolled multi-morbidities. At discharge, effort should be taken to provide the greatest value in prescribing for our patients. By utilizing cost comparison applications, physicians and patients can help maximize savings.
Methods: We retrospectively reviewed discharged medication of 100 consecutive patients. 608 different drug combinations were analyzed. Price variability was determined between the highest prices and lowest prices for non-OTC prescriptions using the Good-Rx® website (a proxy for U.S. commercial prescription prices). We calculated the minimum, maximum, average and median number of prescriptions at discharge from the hospital, and cost per patient for discharge medications based on the highest prices, lowest prices and difference between prices (delta).
Results: From 100 patients, the average number of discharge medications was 6.2 per patient (median = 6). Average costs ranged—lowest price: $275 to highest price: $483 (delta = $207). Median costs range—lowest price: $79 to highest price: $275 (delta = $148). Minimum patient cost: $0, one patient required zero discharge medications. Patients with the highest number of discharge prescriptions medication (18) cost range—lowest price: $2600 to highest price: $3281 (delta = $1,141).
Conclusions: Our results show varying costs of discharge medications. Using the median 6 prescriptions, we found an overall price difference of $148, a variation of $24 per drug between pharmacies. Common drugs appear to have less variability in prices (i.e. furosemide), while uncommon or newer drugs are highly variable (i.e. Linagliptin). A savings of $24 can potentially allow patients to afford more prescriptions, as some common medications start at $4. There are a multitude of barriers to patient adherence. We focus on one key concern—prescription medication expense. Our analysis showed widely varying price patterns between U.S. pharmacies. The difference could represent hundreds of dollars when multiple discharge prescriptions are required. Physicians need to be cost conscious. It is important that we educate ourselves to new technologies and enhance our perspective of wise prescription consumerism. Use of price comparison tools can help direct patients to more affordable resources and aid in medical compliance. While we advocate for patient awareness about these tools—website or mobile application—we neither advocate for one tool nor any specific commercial pharmacy.