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Drug Cost Comparison Web Sites Criticized

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Published: February 14, 2008

TRENTON, N.J. - Web sites operated by numerous states to help consumers compare pharmacy prices for prescription drugs often have missing and sometimes outdated or inaccurate information, a nonpartisan health research group has found.

A report released Wednesday, funded by two health care foundations ahead of California's planned launch of its own site, recommends significant changes to make the sites useful for more patients.

The Washington-based Center for Studying Health System Change examined prescription comparison shopping sites operated by 10 states: Florida, Connecticut, Maryland, Michigan, Minnesota, Missouri, New Hampshire, New Jersey, New York and Vermont.

The sites allow consumers to look at different pharmacies' prices, but the number of drugs listed varies widely by states, from just 26 in Maryland to roughly 400 in Minnesota.
Spot checks of prices found some listings were incorrect, and only New Jersey's site says when the price was last updated, the report said. Some sites don't list prices for each dosage or form of the medicine, such as capsule and liquid.

Most make users sort by one ZIP code or town at a time, rather than within a certain distance from that area. Also, only Florida and New Jersey offer the service in Spanish.

The biggest problem found was that only New York state got its price data by frequently asking pharmacies for it. In every other state, prices come from Medicaid claims filed by pharmacies that sometimes, but not always, list the "usual and customary price" that pharmacy charges for the drug. That's the price that would be charged to uninsured consumers - the primary target for the sites.

Any pharmacy, however, that didn't seek reimbursement for a particular drug through Medicaid within the last month or so would have no price listed for that drug. That was true even for the 10 most widely used drugs, based on an intensive analysis the researchers did in urban, suburban and rural areas of Florida.

They found more than half the pharmacies in Leon County in the Tallahassee area had missing prices for all 10 of those drugs, for example.

"If there's a lot of missing data for the most commonly prescribed drugs, then there's likely to be even more missing data for less commonly used drugs," said the study's lead author, Ha Tu.

Tu is a senior health researcher at the center, funded primarily by the Plainsboro, N.J.-based Robert Wood Johnson Foundation, which paid for the study along with the California HealthCare Foundation.

Among other changes, the report recommends the Web sites also list prices from online pharmacies such as drugstore.com and require pharmacies to turn in prescription price lists every month or so to eliminate data gaps, something several states have evaluated but none have done.

"That really creates a burden on each individual pharmacy," so it's not under consideration in New Jersey, said Division of Consumer Affairs spokesman Jeff Lamm.

He said New Jersey's site, which started Sept. 1, 2007, had 295,000 hits by year's end - along with plenty of feedback from users.

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