Survey of the Prices of Topical Compounded Medications for Alopecia in the Tri-State Area
March 2024 | Volume 23 | Issue 3 | 168 | Copyright © March 2024
Published online February 14, 2024
Janet Choi BSa, Kelly Hawkins BSa, Eliza Balazic BSa, Shaveonte Graham BAb, Chesahna Kindred MDc, Kseniya Kobets MD MHSd
aAlbert Einstein College of Medicine, Bronx, NY
bWright State University Boonshoft School of Medicine, Fairborn, OH
cHoward University, Washington, DC
dMontefiore Medical Center, Einstein-Montefiore Department of Medicine, Division of Dermatology, Elmsford, NY
Abstract
Background: Currently, there is only one topical medication approved by the U.S. Food and Drug Administration for alopecia, minoxidil 2.5% and 5%. With limited options, dermatologists often turn to compounding pharmacies for customized topical alopecia medications.
Objectives: (1) to investigate the pricing and availabilities of compounded topical alopecia medications and (2) to investigate the delivery/mail options available.
Methods: 103 dermatological compounding pharmacies in the tri-state area were contacted. Data were collected on the prices of 11 different compounded formulations for alopecia, the highest concentration of minoxidil available, compounding accreditation status, and delivery.
Results: The majority (76.7% [79/103]) of pharmacies surveyed were responsive. Mean prices for 60 g or mL of medication were $70.44 for minoxidil 5%, $86.95 for minoxidil 5%/finasteride 0.5%, $159.13 for minoxidil 5%/bimatoprost 0.03%, $141.91 for minoxidil 5%/latanoprost 0.02%, $75.31 for finasteride 0.5%, $204.41 for tacrolimus 0.3%, $220.11 for tacrolimus 0.3%/minoxidil 5%/clobetasol 0.05%, $71.44 for cetirizine 1%, $74.93 for metformin 10%, $4,273.20 for tofacitinib 2%, and $1,840.42 for ruxolitinib 2%. Nearly all (93.5% [72/77]) of the pharmacies reported being able to compound minoxidil higher than the commercially available 5%, while 67.6% (50/74) were able to customize minoxidil to be made with <10% alcohol. Just over half (56.4% [44/78]) of the pharmacies were able to deliver to all tri-state areas. The mean delivery fee of pharmacies was $5.93 (n=77). Almost all of the pharmacies (98.7% [76/77]) claimed to be able to process and deliver medications within a week. If pharmacies were not located in the local vicinity, 44.6% (29/65) used a mailing service.
Conclusion: This survey serves to expand clinicians' and patients' knowledge of the options and prices of topical compounded medications for alopecia.
J Drugs Dermatol. 2024;23(3):168-172 doi:10.36849/JDD.7697
INTRODUCTION
Compounding pharmacies are pharmacies that can prepare unique formulations of topical medications, modify existing formulations of drugs, and create a variety of off-label formulations specific to a patient's needs. These pharmacies can be particularly useful to dermatologists as different topical active ingredients can be prepared outside of what is commercially available. Alopecia is one condition for which dermatologists commonly rely on compounding pharmacies. Currently, only one topical medication, minoxidil (2.5% and 5%), is approved by the United States Food and Drug Administration (FDA) for the treatment of alopecia.
1 This medication is currently only available commercially in foam and solution form.
According to the American Pharmacists Association, there are over 7,500 pharmacies in the U.S. that specialize in compounding services. Treatments for alopecia are often not covered by insurance, and the out-of-pocket costs of these medications are highly dependent on the pharmacy itself. As information on the prices and formulations of these compounds is not readily available, a survey was created to address this lack of knowledge.
This study aims to investigate the pricing and availabilities of compounded topical alopecia medications and to investigate the delivery and mailing options available.
