title: Evaluating availability and price of essential medicines in Boston area (Massachusetts, USA) using WHO/HAI methodology.
abstract: BACKGROUND
  Many patients even those with health insurance pay out-of-pocket for medicines. We investigated the availability and prices of essential medicines in the Boston area.
  
  
  METHODS
  Using the WHO/HAI methodology, availability and undiscounted price data for both originator brand (OB) and lowest price generic (LPG) equivalent versions of 25 essential medicines (14 prescription; 11 over-the-counter (OTC)) were obtained from 17 private pharmacies. The inclusion and prices of 26 essential medicines in seven pharmacy discount programs were also studied. The medicine prices were compared with international reference prices (IRPs).
  
  
  RESULTS
  In surveyed pharmacies, the OB medicines were less available as compared to the generics. The OB and LPG versions of OTC medicines were 21.33 and 11.53 times the IRP, respectively. The median prices of prescription medicines were higher, with OB and LPG versions at 158.14 and 38.03 times the IRP, respectively. In studied pharmacy discount programs, the price ratios of surveyed medicines varied from 4.4-13.9.
  
  
  CONCLUSIONS
  While noting the WHO target that consumers should pay no more than four times the IRPs, medicine prices were considerably higher in the Boston area. The prices for medicines included in the pharmacy discount programs were closest to WHO's target. Consumers should shop around, as medicine inclusion and prices vary across discount programs. In order for consumers to identify meaningful potential savings through comparison shopping, price transparency is needed.
authors.affiliation: Department of Global Health, Boston University School of Public Health, Boston, MA USA ; Center for Global Health and Development, Boston University School of Public Health, Boston, MA USA ; Precision Health Economics, Boston, MA USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Global Health, Boston University School of Public Health, Boston, MA USA.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Rorden
authors.affiliation: Health Action International, Amsterdam, The Netherlands.
authors.forename: Margaret
authors.initials: M
authors.lastname: Ewen
authors.affiliation: Department of Global Health, Boston University School of Public Health, Boston, MA USA.
authors.forename: Richard
authors.identifier: 0000-0002-3825-217X
authors.initials: R
authors.lastname: Laing