Neurologic Medication Costs in a Direct-to-Consumer Pharmacy vs Commercial Insurance Plans.

Area of Science:

• Health Economics
• Pharmacoeconomics
• Neurology

Background:

• Rising costs of neurologic medications necessitate exploring cost-saving alternatives.
• Direct-to-consumer (DTC) pharmacies present a potential option for reducing medication expenses.

Purpose of the Study:

• To compare the estimated 2024 costs of neurologic medications from commercial insurance plans with pricing from a DTC pharmacy.
• To analyze out-of-pocket (OOP) and total cost differences between DTC and commercial pharmacy options.

Main Methods:

• A cross-sectional study compared DTC pharmacy prices with model-estimated 2024 commercial and Medicare supplemental costs.
• Medication costs were obtained from commercial insurance data (2012-2021) and DTC pharmacy website (December 10, 2024).
• Calculated differences in annual OOP and total costs for 33 neurologic medications.

Main Results:

• DTC pharmacy OOP costs were 75% higher, but total costs were 413% lower than commercial pharmacies.
• Only teriflunomide and droxidopa showed lower OOP and total costs in the DTC pharmacy.
• 55% of DTC medications had lower total annual costs, with significant reductions for teriflunomide, droxidopa, and dimethyl fumarate.

Conclusions:

• DTC pharmacies can offer comparable OOP costs for uninsured patients and significantly lower total costs for certain neurologic drugs.
• Widespread adoption of DTC pharmacy cost structures could potentially reduce overall prescription expenditures.
• Healthcare providers should consider DTC pharmacies as a viable option for patients managing neurologic medication costs.