Cost comparison of phosphodiesterase type 5 inhibitors: rural vs urban New York State counties and online pharmacies.

Background: Phosphodiesterase type 5 (PDE5) inhibitors are used to treat erectile dysfunction, but their cost can limit access. Aim: This study examines PDE5 inhibitors pricing and demographic data across rural and urban New York State (NYS) counties, as well as small, large, and online pharmacies. Methods: Prices from 133 chain pharmacies were collected from 15 randomly selected urban and 15 rural NYS counties. Counties without at least two large chain pharmacies were excluded. Data included small chains ( Outcomes: The cash price of the PDE5 inhibitors across various pharmacy chain types and county types. Results: Prices were lower in small chain pharmacies compared to larger chains ( Clinical Translation: This study aims to highlight the pricing variability of PDE5 inhibitors to help patients identify cost-effective options to circumvent potential financial barriers. Strengths and Limitations: This study was the first to examine PDE5 inhibitors pricing specifically within rural populations while also providing a comparative analysis of pricing differences between small and large pharmacy chains serving these communities. The study's limitations include a relatively small sample size of rural and small chain pharmacies resulting in power levels of 75% and 69%, respectively, which may impact the generalizability of the findings. Conclusion: Enhancing drug price transparency for PDE5 inhibitors is vital for increasing access and pricing flexibility.