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StreetRx Price Comparison

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Dr. Nabarun Dasgupta presents StreetRx Price Comparison presentation at RADARS Annual Meeting

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StreetRx Price Comparison

  1. 1. StreetRx Price Comparison Non-BulkvsBulk
  2. 2. StreetRx.com THE RADARS® SYSTEM StreetRx has been part of the RADARS System since 2010. The Researched Abuse, Diversion and Addiction-Related Surveillance collects timely product- and geographically- specific data on rates of abuse, misuse, and diversion, contributing to the understanding of trends and aiding the development of effective interventions. StreetRx (streetrx.com) is a collection of databases, websites, and citizen reports enabling real-time collection, organization, and display of street price data on diverted pharmaceutical controlled substances. Based on principles of crowdsourcing for public health surveillance, the site allows users to anonymously submit prices they paid or heard were paid for diverted prescription drugs.
  3. 3. Unique Visitors per Day 130 250 1641 2616 Mobile Accounts for 80% of visits Search 86% of visits come from organic search Average daily visitors per year identified by Google Analytics 2012 2015 As of April 27, 2015. Not to scale.
  4. 4. Visitor DemographicsBased on 58% of known demographics from Google account users 20% Male 35+ years-old 43% Male 18-34 years-old 15% Female 35+ years-old 22% Female 18-34 years-old As captured by Google Analytics. January 1 through March 31, 2015
  5. 5. 42,058 Referrals to Health OrganizationsFrom November 1, 2010 through March 31, 2015 Drug Treatment & Harm Reduction Substance abuse treatment locators, overdose prevention Chronic Pain Advocacy and support organizations Proper Disposal and Storage DEA and non-profit organizations 1,750 1,438 1,318 1,420 4,565 1,356 1,432 2,062
  6. 6. Percent Discount for ADF Versions Putative abuse-deterrent formulation versus unprotected formulations with same active ingredient, using statistical comparison that is less influenced by outliers. Physical Barrier Prodrug(Partial-) Antagonist Concerta Exalgo OpanaER OxyContinOP Zohydro Vyvanse codeine Suboxone tablet XartemisXR p<.01 z -38 p<.01 z -38 p<.01 z -3.0 p<.01 z -3.7 p=.78 z 0.3 p<.01 z -8.6 p<.01 z -13 p=.34 z -0.9 p=.24 z -1.2 TBD ? OROSOROSINTAC INTAC PolyOx RitalinLA p<.01 z -3.9 SODAS NucyntaER p=.10 z -1.6 INTAC HysinglaER p=0.46 z -0.7 INTAC INTAC
  7. 7. Which drugs have greatest volume discounts?On the black market STEP1 STEP3 STEP2 STEP4 USA Data in USD Nov 1, 2010 through Mar 31, 2015 Solid oral formulations Compare bulk (10+ units) purchases with “retail” purchases, by active ingredient N = 52,849 Price per milligram Geometric means and 95% CI Non-parametric Wilcoxan rank-sum (Mann-Whitney) tests Benzodiazepines Muscle Relaxers Stimulants Erectile Dysfunction
  8. 8. BenzodiazepinesPercent discount for bulk purchases (10+ at a time) diazepam n=507 z=3.7 p<0.01 34% 25% 22% 10% clonazepam n=3,161 z=6.1 p<0.01 alprazolam n=4,583 z=8.7 p<0.01 lorazepam n=1,271 z=1.8 p=0.07
  9. 9. Muscle Relaxers & Neuropathic Pain RelieversPercent discount for bulk purchases (10+ at a time) pregabalin n=21 z=1.3 p=0.19 48% 46% 22% 0% gabapentin n=146 z=1.2 p=0.25 carisoprodol n=239 z=3.6 p<0.01 tizanidine n=47 ns
  10. 10. SleepAidsPercent discount for bulk purchases (10+ at a time) eszopiclone n=9 z=0.5 p=0.60 59% 30% 24% zolpidem n=287 z=3.3 p<0.01 zaleplon n=8 z=0.5 p=0.61
  11. 11. Erectile DysfunctionPercent discount for bulk purchases (10+ at a time) tadalafil n=142 z=4.0 p<0.01 73% 61% 0%vardenafil n=15 ns sildenafil n=251 z=3.8 p<0.01
  12. 12. Percent Discount for Bulk Purchase Sleep Aids Erectile DysfunctionBenzodiazepines Stimulants Opioid AnalgesicsMuscle Relaxants 39% 23% 14% 38% 12% 67%
  13. 13. Thank You Boston, MA nabarun@epidemico.com @street_rx @epidemico epidemico.com
  14. 14. OpioidsPercent discount for bulk purchases (10+ at a time) methadone n=852 z=2.6 p<0.01 oxycodone n=9,910 z=8.6 p<0.01 hydromorphone n=1,664 z=2.8 p<0.01 hydrocodone n=6,062 z=7.0 p<0.01 14% 13% 12% 10%
  15. 15. StimulantsPercent discount for bulk purchases (10+ at a time) modafinil n=87 z=1.5 p=0.13 32% 15% 8% 3% methylphenidate n=1,607 z=1.7 p=0.09 amphetamines n=13,828 z=9.1 p<0.01 lisdexamphetamine n=2,038 z=1.8 p=0.07
  16. 16. Descriptive Results Abuse/tamper deterrent formulation Original unprotected formulation 95% Confidence interval of the geometric mean

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