Prescription drugs generally cost more in the US than in other countries. And a new analysis found this is especially true in Boston, where consumers can expect to pay many times more for their medicines than the international benchmark pricing used by the World Health Organization.
The median costs of brand-name and generic drugs in Boston were 158 and 38 times higher, respectively, than the international benchmark. Similarly, median costs for brand-name and store-brand over-the-counter medicines were 21 and 11 times higher than the benchmark, according to the analysis, which was published in the Journal of Pharmaceutical Policy and Practice.
“Very few people pay the full price (for prescription medicines), because they typically have some type of insurance, but we’re showing that even with those discounts, they’re still paying more” than in other countries, said Richard Laing, a professor of international health at Boston University, who led the analysis. He noted that the WHO set a target of four times the international benchmark as an acceptable pricing level for consumers.
Laing explained that Consumer Reports regularly examines pricing for some drugs around the US, but does not compare prices to the international reference price, which the WHO and Health Action International, an advocacy group, use to track affordability. (The pricing for other countries can be found on a website run by the Management Sciences for Health, a nonprofit based in the US.)
So Laing and his team canvassed Boston-area pharmacies to gain further insight into how prices compare with foreign markets. He chose Boston for the simple reason that he lives and works in the region, but he explained that the metropolitan area is as good as any other as a litmus test for making comparisons with US pricing and other countries.
They gathered prices for 50 medicines that are considered to be essential for meeting health care needs, according to the WHO. These include various treatments for high cholesterol, high blood pressure, diabetes, depression, and infections. The over-the-counter medicines that are considered essential include treatments for headaches, heartburn, and allergies.
As part of the effort, the researchers visited not only independent and chain-store pharmacies, such as CVS and Walgreens, but also large retailers that have pharmacy departments. Among them were Walmart, Sam’s Club, and Target, as well as the Hannaford and Jewel-Osco supermarket chains.
In fact, the survey found that the median prices for all prescription medicines at Walmart and Target were much lower than in independent and chain pharmacies. At Walmart and Target, for instance, the median price for these drugs was 4.4 times higher than the international benchmark, which nearly matches the WHO recommendation. The retailers have a program offering prescription drugs for $4.
However, not all of the large retailers carry all of the drugs. Walmart and Target may offer the lowest median price for a brand-name or generic medicine, but only stocked half of the drugs needed for acute illnesses, such as an infection. And the retailers carried just 37 percent of the treatments for chronic ailments, such as high blood pressure.
It’s also worth noting that median prices varied among the chain and independent pharmacies. For instance, brand-name drugs at chain pharmacies were 180 times the benchmark and 188 times higher at independents. But generics were 39 times higher at chains and 31 times higher at independents. Laing explained independents often stock more generics, because these may offer higher reimbursement fees.
“The message is that consumers need to be aware of the range of prices and shop around,” Laing told us. “There’s a general lack of information about the prices of medicines. But there is an opportunity for individuals to see what they would have to pay. In some circumstances, the pharmacy may be the best bet. They may give continuity of care, such as advice and reminders. But options do exist, if you look.”