Services provided by community pharmacies in Wayne County, Michigan: a comparison by ZIP code characteristics

Area of Science:

• Health Services Research
• Pharmacoepidemiology
• Health Disparities Research

Background:

• Access to essential pharmacy services and medication affordability are crucial for public health.
• Socioeconomic and demographic factors may influence the availability and cost of these services.
• Understanding these variations is key to addressing health inequities.

Purpose of the Study:

• To document pharmacy services and medication costs in a diverse Michigan county.
• To investigate associations between pharmacy service availability, medication prices, and resident characteristics at the ZIP code level.

Main Methods:

• A cross-sectional telephone survey of 503 pharmacies across 63 ZIP codes in Wayne County, Michigan.
• Data collection included medication costs (levothyroxine, atorvastatin), service availability (discount programs, home delivery, immunizations), and pharmacy hours.
• ZIP code-level census data on race, income, age, and population density were analyzed.

Main Results:

• Average out-of-pocket costs were $10.01 for levothyroxine and $140.45 for atorvastatin (Lipitor).
• Services like discount generic programs (66.9%), home delivery (44.5%), and immunizations (46.7%) varied significantly.
• ZIP codes with higher income and a larger white population showed lower levothyroxine prices and greater availability of services.

Conclusions:

• Significant disparities exist in generic levothyroxine pricing and access to key pharmacy services based on race and household income.
• These findings underscore socioeconomic and racial inequities in healthcare access within a major metropolitan area.
• Targeted interventions may be needed to mitigate these disparities and improve equitable access to pharmacy care.