Pharmacy Deserts, Prices of Recommended Skin Care Products May Widen Atopic Dermatitis Equity Gap | AAD 2024

A study of the distribution of pharmacies in Chicago showed that retail pharmacies were 20 times more common in higher-income ZIP codes than in lower-income ones, results that add to the growing body of evidence about “pharmacy deserts” in the U.S.

In a two-part study, Stephanie Cardenas, a third-year medical student at the University of Chicago Pritzker School of Medicine and her colleagues, also showed that over-the-counter products recommended by the National Eczema Foundation were more expensive than the creams and lotions most commonly used. The results were shown yesterday in a poster presented at the annual meeting of the American Academy of Dermatology meeting in San Diego.

Their findings suggest factors that could further worsen healthcare inequity, say the researchers, citing previous research showing that patients with atopic dermatitis have approximately $1,000 in out-of-pocket expenses a year and that Black patients tend to spend more than that.

Pharmacy deserts is a term that plays off the term “food deserts,” which was coined to describe the relative shortage of retail outlets selling healthful foods in lower-income neighborhoods. Pharmacy deserts have become a major concern as CVS and Walgreens Boots Alliance have moved to shutter hundreds of retail outlets and Rite Aid declared bankruptcy. CVS closed 600 stores last year and has announced plans to close 300 more this year. Walgreens Boots Alliance announced a plan last year to close about 150 of its iconic retail outlets.

Cardenas and her colleague used Quantum Geographic Information System software map the density of pharmacy retailers in Chicago by ZIP code. The retailers included Target, Walgreens, CVS, Walmart and Meijer, a grocery store chain in the Midwest. They found that the ZIP codes in the bottom 10% by median income had .22 retailers per 10,000 population compared with 4.49 per 10,000 population in those in the top 10% by median income.

Although a wide array of prescription products is used to treat atopic dermatitis, patients also often use cream, lotions and liquid body soaps to ease the condition. Cardenas used information from the Statista.com and product rankings from Amazon to create a list of the most popularly purchased items.

They found that that the products with the imprimatur of a National Eczema Foundation recommendation were more expensive than most popularly purchased items. For example, the lotions recommended by the foundation were priced, on average, at $2.72 per ounce compared with $1.13 per ounce. Similarly, the foundation-favored liquid body soaps cost, on average, $1.30 per ounce compared with 35 cents per ounce for the most popularly purchased items. It was the same story with creams: $5.96 per ounce for the foundation-recommended products compared with $4.79 per ounce for those most popularly purchased.

Although it was not part of their analysis, the data in the poster show that Amazon prices were often higher than those at the retail outlet.For example, the average price of the foundation-recommended creams on Amazon were $12.07 per ounce. The next highest price was $7.22 per ounce at Target.

For equity reasons, Cardenas said poster session that “dermatologists like you all must advocate for affordable gentle skin care and for pharmacy deserts to be addressed.”