{"title":"Cost comparison of phosphodiesterase type 5 inhibitors: rural vs urban New York State counties and online pharmacies.","authors":"Sofia Maurina Di Scipio, Aaron Katz","doi":"10.1093/sexmed/qfaf031","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Phosphodiesterase type 5 (PDE5) inhibitors are used to treat erectile dysfunction, but their cost can limit access.</p><p><strong>Aim: </strong>This study examines PDE5 inhibitors pricing and demographic data across rural and urban New York State (NYS) counties, as well as small, large, and online pharmacies.</p><p><strong>Methods: </strong>Prices from 133 chain pharmacies were collected from 15 randomly selected urban and 15 rural NYS counties. Counties without at least two large chain pharmacies were excluded. Data included small chains (<i>n</i> = 49), large chains (<i>n</i> = 84), rural (<i>n</i> = 57), urban (<i>n</i> = 76), and online pharmacies (<i>n</i> = 12). Prices for 20 tablets of sildenafil (100 mg) and tadalafil (20 mg) were gathered using GoodRx standard coupons. Price per unit for online pharmacies was calculated for quantities closest to 20 pills. Demographic data was sourced from the U.S. Census Bureau. This study was considered exempt from IRB review. Statistical analyses including <i>t</i>-tests, Wilcoxon rank-sum, and Kruskal-Wallis tests were performed using R Version 4.4.1 (2024-06-14).</p><p><strong>Outcomes: </strong>The cash price of the PDE5 inhibitors across various pharmacy chain types and county types.</p><p><strong>Results: </strong>Prices were lower in small chain pharmacies compared to larger chains (<i>P</i> < .001), but did not significantly differ between rural and urban counties (<i>P</i> > .6). Small chain rural pharmacies were cheaper than urban counterparts for sildenafil (<i>P</i> = .032). Online pharmacies offered the lowest and highest prices, with significant differences by chain type (<i>P</i> < .001) but not by county type (<i>P</i> > .100) for both drugs. Rural counties had a smaller Native Hawaiian (<i>P</i> = .001), Asian, Black/African American population and a larger White (<i>P</i> < .001) and American Indian population (<i>P</i> = .031). Median income was higher in urban counties (<i>P</i> = .010), but the percentage of the population without health insurance coverage did not differ (<i>P</i> = .177).</p><p><strong>Clinical translation: </strong>This study aims to highlight the pricing variability of PDE5 inhibitors to help patients identify cost-effective options to circumvent potential financial barriers.</p><p><strong>Strengths and limitations: </strong>This study was the first to examine PDE5 inhibitors pricing specifically within rural populations while also providing a comparative analysis of pricing differences between small and large pharmacy chains serving these communities. The study's limitations include a relatively small sample size of rural and small chain pharmacies resulting in power levels of 75% and 69%, respectively, which may impact the generalizability of the findings.</p><p><strong>Conclusion: </strong>Enhancing drug price transparency for PDE5 inhibitors is vital for increasing access and pricing flexibility.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 3","pages":"qfaf031"},"PeriodicalIF":2.6000,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151535/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sexual Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/sexmed/qfaf031","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Phosphodiesterase type 5 (PDE5) inhibitors are used to treat erectile dysfunction, but their cost can limit access.
Aim: This study examines PDE5 inhibitors pricing and demographic data across rural and urban New York State (NYS) counties, as well as small, large, and online pharmacies.
Methods: Prices from 133 chain pharmacies were collected from 15 randomly selected urban and 15 rural NYS counties. Counties without at least two large chain pharmacies were excluded. Data included small chains (n = 49), large chains (n = 84), rural (n = 57), urban (n = 76), and online pharmacies (n = 12). Prices for 20 tablets of sildenafil (100 mg) and tadalafil (20 mg) were gathered using GoodRx standard coupons. Price per unit for online pharmacies was calculated for quantities closest to 20 pills. Demographic data was sourced from the U.S. Census Bureau. This study was considered exempt from IRB review. Statistical analyses including t-tests, Wilcoxon rank-sum, and Kruskal-Wallis tests were performed using R Version 4.4.1 (2024-06-14).
Outcomes: The cash price of the PDE5 inhibitors across various pharmacy chain types and county types.
Results: Prices were lower in small chain pharmacies compared to larger chains (P < .001), but did not significantly differ between rural and urban counties (P > .6). Small chain rural pharmacies were cheaper than urban counterparts for sildenafil (P = .032). Online pharmacies offered the lowest and highest prices, with significant differences by chain type (P < .001) but not by county type (P > .100) for both drugs. Rural counties had a smaller Native Hawaiian (P = .001), Asian, Black/African American population and a larger White (P < .001) and American Indian population (P = .031). Median income was higher in urban counties (P = .010), but the percentage of the population without health insurance coverage did not differ (P = .177).
Clinical translation: This study aims to highlight the pricing variability of PDE5 inhibitors to help patients identify cost-effective options to circumvent potential financial barriers.
Strengths and limitations: This study was the first to examine PDE5 inhibitors pricing specifically within rural populations while also providing a comparative analysis of pricing differences between small and large pharmacy chains serving these communities. The study's limitations include a relatively small sample size of rural and small chain pharmacies resulting in power levels of 75% and 69%, respectively, which may impact the generalizability of the findings.
Conclusion: Enhancing drug price transparency for PDE5 inhibitors is vital for increasing access and pricing flexibility.
期刊介绍：
Sexual Medicine is an official publication of the International Society for Sexual Medicine, and serves the field as the peer-reviewed, open access journal for rapid dissemination of multidisciplinary clinical and basic research in all areas of global sexual medicine, and particularly acts as a venue for topics of regional or sub-specialty interest. The journal is focused on issues in clinical medicine and epidemiology but also publishes basic science papers with particular relevance to specific populations. Sexual Medicine offers clinicians and researchers a rapid route to publication and the opportunity to publish in a broadly distributed and highly visible global forum. The journal publishes high quality articles from all over the world and actively seeks submissions from countries with expanding sexual medicine communities. Sexual Medicine relies on the same expert panel of editors and reviewers as The Journal of Sexual Medicine and Sexual Medicine Reviews.
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