INTRODUCTION
The high cost of prescription medications continues to be a challenge for patients and prescribers in dermatology. Strategies to control drug expenditures and to decrease healthcare spending in the U.S. have contributed to higher deductibles and copayments, as well as more restrictive third-party formulary listings.1 To add to the burden, the costs of generic medications commonly prescribed in dermatology have risen dramatically. From 2005 to 2016, the average wholesale price of topical generic and branded medications increased by 273% and 379%, respectively.2 Rising drug costs present a particularly challenging issue for older adults, a population at increased risk for cost-related medication nonadherence in association with multiple comorbidities, lower socioeconomic status, and functional limitations.3
In March 2019, Ortho Dermatologics launched Dermatology.com, a cash-pay prescription program in dermatology with the stated mission of providing patients with direct access to branded dermatology medicines at lower, predictable prices. The program does not accept any form of insurance, thus eliminating co-pays, unpredictable pricing, and prior-authorizations from the process of filling prescriptions. Dermatology.com providesproducts that treat a number of dermatologic conditions at prices ranging from $50 to $115.4 Prescriptions can be delivered directly to patients using Medvantx, an online pharmacy associated with Dermatology.com (https://www.medvantxrx.com/), or they can be picked up at a local Walgreens. One of the products available on Dermatology.com is topical 5-fluorouracil (5-FU) 5% cream at the fixed cost of $85 for 40g. Topical 5-FU is an effective treatment for actinic keratoses (AK), a highly prevalent condition among older, fair-skinned individuals with Medicare.5 However, topical 5-FU has been associated with high retail prices and out-of-pocket costs.6
A recent study reported a 1,240% increase in the cost of branded topical antineoplastic products from 2009 to 2015.8 An online, fixed price pharmacy site could potentially help alleviate the concern of rising drug prices for older adults with Medicare by providing direct access to branded dermatology products with reasonable and predictable prices. However, the online platform may be less accessible to older adults, a population with lower access to and usage of the internet.9 The purpose of this study was to determine if older Medicare patients utilize the online pharmacy in proportion to national data on the amount of similarly aged Medicare patients prescribed topical 5-FU for AK.
In March 2019, Ortho Dermatologics launched Dermatology.com, a cash-pay prescription program in dermatology with the stated mission of providing patients with direct access to branded dermatology medicines at lower, predictable prices. The program does not accept any form of insurance, thus eliminating co-pays, unpredictable pricing, and prior-authorizations from the process of filling prescriptions. Dermatology.com providesproducts that treat a number of dermatologic conditions at prices ranging from $50 to $115.4 Prescriptions can be delivered directly to patients using Medvantx, an online pharmacy associated with Dermatology.com (https://www.medvantxrx.com/), or they can be picked up at a local Walgreens. One of the products available on Dermatology.com is topical 5-fluorouracil (5-FU) 5% cream at the fixed cost of $85 for 40g. Topical 5-FU is an effective treatment for actinic keratoses (AK), a highly prevalent condition among older, fair-skinned individuals with Medicare.5 However, topical 5-FU has been associated with high retail prices and out-of-pocket costs.6
A recent study reported a 1,240% increase in the cost of branded topical antineoplastic products from 2009 to 2015.8 An online, fixed price pharmacy site could potentially help alleviate the concern of rising drug prices for older adults with Medicare by providing direct access to branded dermatology products with reasonable and predictable prices. However, the online platform may be less accessible to older adults, a population with lower access to and usage of the internet.9 The purpose of this study was to determine if older Medicare patients utilize the online pharmacy in proportion to national data on the amount of similarly aged Medicare patients prescribed topical 5-FU for AK.
