Services provided by community pharmacies in Wayne County, Michigan: a comparison by ZIP code characteristics.
OBJECTIVE
To document the availability of selected pharmacy services and out-of-pocket cost of medication throughout a diverse county in Michigan and to assess possible associations between availability of services and price of medication and characteristics of residents of the ZIP codes in which the pharmacies were located.


METHODS
Cross-sectional telephone survey of pharmacies coupled with ZIP code-level census data.


METHODS
503 pharmacies throughout the 63 ZIP codes of Wayne County, MI.


METHODS
The out-of-pocket cost for a 30 days' supply of levothyroxine 50 mcg and brand-name atorvastatin (Lipitor-Pfizer) 20 mg, availability of discount generic drug programs, home delivery of medications, hours of pharmacy operation, and availability of pharmacy-based immunization services. Census data aggregated at the ZIP code level included race, annual household income, age, and number of residents per pharmacy.


RESULTS
The overall results per ZIP code showed that the average cost for levothyroxine was $10.01 ± $2.29 and $140.45 + $14.70 for Lipitor. Per ZIP code, the mean (± SD) percentages of pharmacies offering discount generic drug programs was 66.9% ± 15.0%; home delivery of medications was 44.5% ± 22.7%; and immunization for influenza was 46.7% ± 24.3% of pharmacies. The mean (± SD) hours of operation per pharmacy per ZIP code was 67.0 ± 25.2. ZIP codes with higher household income as well as higher percentage of residents being white had lower levothyroxine price, greater percentage of pharmacies offering discount generic drug programs, more hours of operation per week, and more pharmacy-based immunization services. The cost of Lipitor was not associated with any ZIP code characteristic.


CONCLUSIONS
Disparities in the cost of generic levothyroxine, the availability of services such as discount generic drug programs, hours of operation, and pharmacy-based immunization services are evident based on race and household income within this diverse metropolitan county.
Steven R
SR
Erickson
Paul
P
Workman
D000069059:Atorvastatin; D003157:Community Pharmacy Services / Q000191:economics*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000191:economics*; D016527:Drug Costs; D016568:Drugs, Generic / Q000191:economics; D019538:Health Care Surveys; D005102:Health Expenditures; D054625:Healthcare Disparities / Q000191:economics*; D006538:Heptanoic Acids / Q000191:economics; D006699:Home Care Services / Q000191:economics; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics; D017589:Immunization Programs / Q000191:economics; D007182:Income; D007252:Influenza Vaccines / Q000191:economics; D008824:Michigan; D011758:Pyrroles / Q000191:economics; D044469:Racial Groups; D012111:Residence Characteristics; D011795:Surveys and Questionnaires; D013689:Telephone; D013974:Thyroxine / Q000191:economics; D013997:Time Factors
D016568:Drugs, Generic; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007252:Influenza Vaccines; D011758:Pyrroles; D000069059:Atorvastatin; D013974:Thyroxine