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A new analysis by GoodRx Research, in collaboration with Henry Ford Health, highlights how costs of topical corticosteroids can differ within potency classes and suggests ways providers can help patients save on their prescriptions. The research was published in the Journal of the American Academy of Dermatology (JAAD).

Topical corticosteroids are medications that are commonly prescribed by dermatologists to treat many skin conditions. However, these medications can have high prices. And as we've seen in previous research, many patients may skip necessary treatments because of cost. Given the chronic nature of the diseases topical corticosteroids treat, it's vital that patients are able to take their medications as prescribed.

In this particular class of drugs, there are many products on the market in a variety of active ingredients and forms, such as ointments, gels, and creams. While the differences between medications are such that the products cannot be substituted for each other at the pharmacy, some are similar enough in strength to be considered suitable alternatives. And these alternatives often come with a lower price tag.

Below are the key findings from our analysis, which can be helpful for both patients and providers.

Topical corticosteroid costs vary widely within potency classes

To examine historical costs of topical corticosteroids, we analyzed prices of 237 topical corticosteroids from 2017 to 2021. We used an all-payer pharmacy database covering over 54,000 pharmacies in 50 states. We separated topical corticosteroids into potency classes (low, medium, high, and ultra) based on their strength profile.

Over the 5-year study period, topical corticosteroid prices largely stabilized. Branded ultra-potent steroids are the exception, however, and increased in price by 63%. At the end of the study period, ultra-potent brand medications averaged $21.55 per unit. This means that a 45 g tube could cost close to $1,000 without insurance coverage.

However, prices vary between potency classes, and generic topical corticosteroids have far lower costs. Generic ultra-potent topical corticosteroids averaged only $5.53 per unit by the end of the study period, and generic medium-potent corticosteroids had the lowest prices at only $2.12 per unit.

Our study found that three drug-level factors had the greatest impact on cost differences:

• Branded products (these had 105% higher cost than generics)

• Drug class (ultra-potent drugs were 55% more than low-potency drugs)

• Drug form (ointments were 20% less costly than creams)

Patients can save by switching to a different topical corticosteroid

Because there are many therapeutically similar topical corticosteroids within potency classes, there are often equally effective products available at a lower cost.

To calculate the potential savings by switching between products, we first identified the medications that had the highest costs (by price per unit, or PPU) in each potency class. We limited this group to medications that were commonly filled to keep the findings more relevant to real-world prescribing behavior. We also identified the medications with the lowest cost for every potency class.

We found that there were large cost savings opportunities in each potency class. For example, the average difference between the highest-cost, ultra-potent drug and the lowest-cost, ultra-potent drug was $12.57 per unit.

Savings are available across all classes, with higher savings potential for higher-potency products. While this chart shows average savings across all commonly filled products, there are even greater savings available when switching from high-cost brand products to generics.

For example, a patient taking Ultravate - a brand lotion that had an average PPU of $18.89 during our study period - could switch to a different ultra-potent steroid. One lower-cost option that is still ultra potent is the generic medication betamethasone dipropionate augmented, which had an average PPU of just $2.63.

These findings mean that if a patient is prescribed a costly topical corticosteroid, a prescriber could likely find an alternative medication in the same potency class for less. Depending on what the clinician determines is appropriate, this could mean switching to a therapeutically similar medication, a generic, or a different form of the medication.

Coupons can help patients afford their prescriptions

Our research also compared GoodRx coupon prices to cash prices for topical corticosteroids from October 2021 through December 2021. We found that coupon prices were consistently lower than cash prices. Differences vary by individual product, but the savings are generally greater for the higher-potency classes.

Coupon prices mirror cash prices and can help providers identify cost savings for patients at the point of care. Providers could potentially use coupon prices to find lower-cost alternatives within the same potency class. They could do this in cases where patients are uninsured or are paying out of pocket due to a high deductible. Patients receiving medications through insurance may face different drug prices.

Summing it all up

While prices for topical corticosteroids have stabilized overall, patients can still save significantly if a prescriber selects a lower-cost alternative. Identifying cost-savings opportunities for these important medications can also help patients be able to take their medication as prescribed.

There are different ways to save on topical corticosteroids without compromising on medication needs. Switching to a lower-cost alternative in the same potency class and/or using coupons from GoodRx are two proven ways to make medication more affordable.

Read about our study methods and all of our findings in the full research paper published in JAAD.

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