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  • Comprehensive Ophthalmology, Uveitis

    This study explored the variation in medication prices between cities in the United States, as well as the disparity in prices between pharmacies within a single city.

    Study design

    The authors conducted a phone survey of 8 nationwide and 5 independent pharmacies in 5 U.S. cities to determine the price without insurance of prednisolone acetate, prednisolone sodium phosphate, difluprednate (Durezol) and loteprednol etabonate (Lotemax).


    Previous multinational studies have confirmed the high prices of ophthalmic medications in the United States relative to other countries. Researchers found that drug prices do not vary significantly between cities. Average prices were not significantly lower at independent pharmacies compared with chain pharmacies for difluprednate (US$211 vs. US$217, P=0.297), but were significantly lower for loteprednol etabonate (US$255 vs. US$275; P<0.001). Prednisolone acetate was slightly cheaper at chain pharmacies, but the difference was not statistically significant (US$49 vs. US$52; P= 0.559).


    Drug pricing is dynamic and difficult to study. This study did not account for the influence of common health insurance carriers in these markets, nor did they examine the use of coupons or other sources of cost savings. This limits the generalizability of these findings.

    Clinical significance

    The high variation in drug prices within the same city suggests that comparison shopping can control costs and potentially reduce cost-related nonadherence, which can limit visual potential and increase the risk of associated events. This paper is a good initial study of a complex issue and can be used as a foundation for future studies. Practically, clinicians should be aware that cost comparison within a city may be beneficial for patients with ocular inflammation and improve cost-related compliance, especially for those patients with limited insurance coverage.