Co-Payments and Average Wholesale Price Vary Widely and Unpredictably for Topical Corticosteroids

Physicians often are unaware of the cost to patients of medications they prescribe. The cost of topical corticosteroids was explored using a national pharmaceutical database that provided a patient's actual co-payment and the average wholesale price for topical corticosteroids of varying potencies.

For all topical corticosteroids, the cost per gram varied widely by amount of medication dispensed. For example, average co-pay for triamcinolone acetonide 0.1% was 12 times higher for a 15-g tube (US$0.24/g) than for a 454-g container ($0.02/g). Co-pays for branded drugs were three to five times higher than co-pays for generic drugs; average co-pay for 60-g clobetasol propionate 0.05% was $32.55 for a branded form versus $7.42 for a generic. Co-p…