Discount listing savings may increase adherence to vaginal estrogen therapy

Using the Mark Cuban Cost Plus Drug Company (CPD) or GoodRx led to significant cost savings, compared with retail and Medicare pricing models, in the prescription of vaginal estrogen, according to a presentation at the 24th Annual Fall Scientific Meeting of Sexual Medicine Society of North America.

Charles A. Loeb, MD

“High medication costs for vaginal estrogen may create a barrier for patients seeking treatment for numerous urinary and vaginal symptoms,” Charles A. Loeb, MD, andrology fellow at the University of California at Irvine, said during the presentation. “Online pharmacy tools, like the Mark Cuban Cost Plus Drug Company and GoodRx, offer methods for medication discount, and this may lead to improved adherence.”

Therefore, the investigators aimed to evaluate the pricing of vaginal estrogen—topical Estrace (estradiol), Vagifem (estradiol vaginal inserts), and topical Premarin (conjugated estrogens)—as advertised by retail pharmacies and Medicare compared with discount listings through CPD and GoodRx.

They compared listed retail and discount prices as advertised on CPD and GoodRx—obtained from data from Costco, CVS, Walgreens, and Walmart pharmacies from the most populous zip code in California, New York, and Texas—vs the average cost per dosage unit described on the Medicare Part D Drug Spending and Utilization 2021 report to determine the average national cost savings after the use of CPD and Medicare.

The average cost per dosage unit for Estrace with discount tools was $0.53, compared with $6.14 with Medicare Part D and $3.14 with retail pricing, for a national savings of $4.1 million. The average cost per dosage unit for Vagifem with discount tools was $3.75, compared with $20.95 with Medicare Part D and $10.19 with retail pricing, for a national savings of $3.4 million. The average cost per dosage unit for Premarin with discount tools was $4.30, compared with $10.10 with Medicare Part D and $5.43 with retail pricing, for a national savings of $185. Million.

“They offer a way to decrease costs for indications,” Loeb said.

He added that the use of CPD over Medicare pricing could result in a combined national savings of $192 million. In addition, the use of CPD or GoodRx, compared with retail pricing, could result in a combined annual national savings of $39.2 million.

“The utilization of CPD and GoodRx in the prescription of vaginal estrogen led to a substantial national average cost savings when compared to retail and Medicare pricing,” the study authors concluded. “CPD and GoodRx may offer a way to decrease the cost burden for patients seeking treatment for urinary and vaginal symptoms and significantly reduce national expenditures on medications.”

Reference:

1. Loeb CA, Miller JA, Moukhtar Hammad MA, Nguyen M, Azad B, Yafi FA. Use of online pharmacy tools may lead to significantly reduced national expenditures on vaginal estrogen. Presented at: 24th Annual Fall Scientific Meeting SMSNA; November 16-18, 2023; San Diego, CA. Abstract 003.