title: Changing availability and cost of Internet physician consultations and prescription medications.
abstract: BACKGROUND
  Internet use by the public to obtain medical information and services continues to grow. In 1999, we found cost of general physician visits was 15% higher, and cost of medications was 10% greater via the Internet than from community providers. The goal of this study was to re-examine changes in product availability and costs to consumers four years later.
  
  
  METHODS
  We searched multiple websites 1 June 2003 - 31 August 2004, offering physician consultations and prescription medications. We compared mean cost of Internet physician visits and price per pill to costs of community-based general physicians and pharmacies in the Philadelphia region.
  
  
  RESULTS
  We found 144 sites worldwide providing physician services and prescription medications. Mean charge for an Internet physician consultation was 55 dollars, 8.3% lower than for a comparable visit to a community practitioner. Mean cost per pill across 204 available medications was 36.7% higher at Internet sites than at local pharmacies. Shipping and handling (S&H) added a mean of 15.40 dollars. Total cost to Internet consumers was similar whether or not Internet sites charged for a physician consultation and/or S&H. Obtaining physician visits and medications over the Internet was about 40% more costly than in the local community.
  
  
  CONCLUSIONS
  The Internet continues to hold great promise for provision of health and medical care services by expanding access. However, increased access to physician care and medications entails higher cost, and quality of physician services and pharmaceuticals provided remain controversial.
authors.affiliation: Department of Medicine, Leonard Davis Institute of Health Economics, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104-2676, USA. bsbloom@mail.med.upenn.edu
authors.forename: Bernard S
authors.initials: BS
authors.lastname: Bloom
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Iannacone
mesh_terms: D005102:Health Expenditures; D006801:Humans; D020407:Internet / Q000191:economics*; D004364:Pharmaceutical Preparations / Q000191:economics*; D010820:Physicians / Q000191:economics*; D019114:Remote Consultation / Q000191:economics*
chemical_list: D004364:Pharmaceutical Preparations