Dr. Jules Lipoff was browsing the pharmacy shelves of his local Target when he stumbled across an interesting finding: Ounce for ounce, the women’s version of Rogaine foam—an over-the-counter treatment for hair loss—cost significantly more than the men’s.
Men’s and women’s Rogaine are marketed differently but contain the same ingredients. “I thought, maybe this is just a fluke,” says Lipoff, assistant professor of dermatology at the University of Pennsylvania Perelman School of Medicine. “But I went to a couple different stores and saw it was pretty consistent.”
Lipoff and his colleagues then compared prices for Rogaine and its generic version, minoxidil, at 21 pharmacies in four states. Their findings, published in JAMA Dermatology, show that the drug is routinely priced higher when marketed for women. Although they only looked at a specific selection of products, the authors say their paper “may reflect the larger issue of gender-based pricing” for many types of health care.
The researchers included Target in their analysis, along with five of the country’s other largest chain pharmacies: CVS, Kroger, Rite Aid, Walgreens and Walmart. From July to November 2016, they recorded the prices, sizes and ingredients of 41 unique minoxidil products at stores in Pennsylvania, New York, Ohio and Indiana.
Rogaine’s foam formulas are the company’s newest, most popular products, and at 5% strength, they are FDA-approved for both men and women. But despite having identical formulations, the researchers found a 40% average increase in the price of the women’s foam version ($11.27 per ounce) compared to the men’s ($8.05 per ounce) when sold at these stores.
Lower-cost generic versions of minoxidil foam are available. But these products are branded for men only, because Rogaine still owns a patent on the women’s foam formula.
A spokesperson for Rogaine told Health that Rogaine foam for men and women are the same price per ounce when purchased directly from the company’s website, and when sold wholesale to pharmacies. “I can’t speak for pricing by individual retailers,” he said in an email. A spokesperson for Target said the company was not able to respond by press time.
The researchers also looked at topical (liquid) minoxidil, which is available for men and women as Rogaine or a generic. It’s an older version of the medicine and is sold for men at 5% strength and for women at 2%. In this case, even though the men’s formula has more active ingredient, the two versions cost about the same: $7.61 on average for women’s and $7.63 for men’s.
“On one hand, we see that women are paying more than men for essentially an identical product,” says Lipoff. “And on the other, we see that they’re paying the same as men for something that’s not as effective.”
Lipoff points out that women’s and men’s versions of these products are sometimes sold in different sizes and quantities, so women may not even realize they’re paying more. To add to the confusion, Rogaine foam is approved for women as a once-daily treatment and for men as a twice-daily treatment—so the same size container is labeled as a two-month supply for women and a one-month supply for men.
But doctors may tell women to use the medicine twice a day for better effectiveness. They may also tell women to buy the men’s 5% topical formula instead of the women’s 2%. Lipoff tells his female patients to buy men’s Rogaine because it’s cheaper. “I would also encourage them to seek out generic versions, whatever is least expensive, because the active ingredients are going to be the same,” he adds.
Gender-based price differences are not new; one 2015 report found that women pay more for personal care products 56% of the time. But since few medications are marketed differently to men and women, it isn’t often that researchers can compare drug costs in this way.
Lipoff says the purpose of his study wasn’t to accuse stores of intentional discrimination, but simply to document and make people aware of the real difference in cost.
“I also hope we can bring forth a larger issue,” he says, “that we should consider how many of our costs in health care—not just medications but things like insurance and medical procedures—could be affected simply by gender.”