Cost and availability of high-dose oral prednisone for management of optic neuritis.

OBJECTIVE

This study assesses the cost and availability of 1250 mg of oral prednisone for treatment of optic neuritis across pharmacies in Toronto.

DESIGN

Prospective cross-sectional study

PARTICIPANTS

Data collected from 70 pharmacies, across 4 regions in Toronto, Ontario, Canada

METHODS

Data were collected from 70 pharmacies on cost and availability for 3- and 5-day courses of prednisone. Pharmacist hesitancy was assessed on the basis of the readiness of the pharmacist to dispense the required dose of medication.

RESULTS

The average cost for a 3-day course of prednisone was $29.10 CAD, and for a 5-day course was $40.40 CAD. Availability was lowest in independent pharmacies (23.8%) and highest in chain pharmacies (47.6%). Although no significant association between availability and pharmacy type was found (χ2 [1; N = 63] = 3.66; p = 0.06), the direction of the effect still shows an indication of chain pharmacies having higher stock. Chain pharmacies also exhibited the highest cost variability. Finally, 40% of pharmacists had some hesitancy or refused to dispense the appropriate dose.

CONCLUSIONS

There is limited availability of high-dose prednisone across Toronto, with chain pharmacies offering the highest availability but at a higher cost. There is significant hesitancy about dispensing this prednisone dose among pharmacists. Clinicians should be aware of these trends when prescribing medication for optic neuritis. Neuro-ophthalmologists should aim to develop relationships with pharmacies to improve timely administration of this medication.