Harriet Lane Handbook app: Unbound vs Skyscape cost, the edition gap, and which one a pediatric resident should buy

There are two Harriet Lane Handbook apps you can buy in the US, and they cost about the same. Unbound Medicine sells it as a one year subscription for $54.95 on its own site, with renewals at $39.95 and web plus app access. Skyscape, the Medpresso app, charges $49.99 a year as an auto-renewing in-app subscription, or $32.99 for six months. We read both at the vendors and on the US App Store in September 2026. The detail that matters more than the $5 gap: both apps still carry the 23rd edition, while Elsevier published the 24th edition in print and ebook in 2026.

So a pediatric intern buying today has a real choice to make, and it is not only between two apps. Below is every way to pay for Harriet Lane on a phone right now, which one we would buy for residency, and where the handbook stops being enough.

Harriet Lane Handbook app prices compared

Two things jump out of that table. First, every app option is a subscription or behaves like one. Unbound calls its $54.95 purchase a one year subscription and renews at $39.95; Skyscape bills automatically every year, six months or three months until you turn it off in your App Store settings at least 24 hours before renewal. Second, the cheapest way into the current 24th edition is not an app at all. It is Elsevier's ebook, which is a one-off purchase with lifetime access.

The apps still sell the 23rd edition

The Harriet Lane Handbook is rewritten every three years by pediatric residents at Johns Hopkins, edited by the chief residents and reviewed by faculty. The 24th edition, ISBN 9780443287510, is now on Elsevier's US store and was selected for the 2026 Doody's Core Titles as an essential purchase in pediatrics. Elsevier lists the 23rd edition as the previous one.

Both app vendors still identify their content by the 23rd edition's ISBN, 9780323876988. Unbound's product page and its App Store in-app purchase are both labeled 23rd edition, and Skyscape's App Store listing licenses its content from the same ISBN. We found no date from either vendor for a 24th edition update.

How much that matters depends on how you use the book. The pediatric drug formulary, maintained by Carlton K. K. Lee, PharmD, is where most residents spend their time, and a three year gap in a formulary is not trivial. If you want the 24th edition's text on day one, buy the ebook. If you want the fastest thumb-driven lookup on rounds and can live with the previous edition for now, either app is fine, and a subscription should carry you into the new edition once the vendor ships it. Ask the vendor before paying if the edition is the deciding factor.

Unbound vs Skyscape: which Harriet Lane app to buy

For most residents we would buy Unbound direct from unboundmedicine.com. The first year costs $5 more than Skyscape's annual plan, but renewal is $10 cheaper, you get the handbook in a browser on the workroom computer as well as on your phone, and the app has the larger and better rated user base. Buying inside the App Store costs $5 more than buying on Unbound's site for what appears to be the same content, so buy on the web and sign in on the phone.

Skyscape wins in two cases. If you only need Harriet Lane for a three month pediatrics rotation as a medical student or a family medicine or emergency medicine resident, $25.99 for three months beats either annual price. And if you like decision flowcharts more than outline text, Skyscape's interactive flowcharts are the stronger feature. Try both free previews on the same three questions you looked up last week before you pay either one.

One warning from Unbound's own App Store reviews: a long-time customer describes having to rebuy apps after an iOS change years ago. Subscriptions sidestep that problem, which is one more reason not to hunt for an old one-time purchase listing.

Is the Harriet Lane app worth paying for as a pediatric resident?

Usually yes, but check two things first. Some residency programs and children's hospitals already license Harriet Lane or a larger reference that includes it, so ask your chief residents or the medical library before you spend your own money. Elsevier's Clinical Pharmacology drug database, for example, includes the Harriet Lane Handbook inside its neonatal and pediatric content; we break that product down in Clinical Pharmacology subscription cost. If your hospital has it, you may already have Harriet Lane without knowing.

If you pay yourself, the math is simple. Around $50 a year buys the pediatric pocket reference Elsevier describes as the most widely used in the world, and if your program gives an education or book allowance, this is exactly what it is for. It is a lot cheaper than the general drug references most residents also carry: epocrates+ is $179.99 a year (the Epocrates cost breakdown covers what the paid tier adds), and a Lexicomp subscription runs $29.99 a month per package. Harriet Lane is the pediatric specialist. It does not replace a general drug database for adult patients you meet on other rotations.

Keep in mind what it is for. Harriet Lane is a point-of-care reference, not a board review book. For the in-training exam and boards you will want a question bank, and some residents also turn their highlighted chapters into practice questions so the reading they already did on the wards doubles as review.

Harriet Lane app vs the Harriet Lane ebook

The ebook and the apps solve different problems. The enhanced ebook on VitalSource Bookshelf is the 24th edition, costs $57.99 at list with lifetime access, and gives you the whole text with search, notes and highlights. It reads like the book, which is good for studying a topic and slower for pulling up one dose at the bedside. The apps are built around lookup: the formulary, calculators and flowcharts are one or two taps away, and that is what you want at 3 a.m. with a febrile infant.

A reasonable split for an intern: buy the 24th edition ebook once for reading, and add an app subscription when you find yourself looking up doses several times a shift. If money is tight and you can only buy one, pick by habit. Readers should buy the ebook; people who look things up in the hallway should buy the app.

Where a pocket reference stops

Harriet Lane tells you the dose. It does not look at the rest of the patient's medication list and tell you, unprompted, that the new drug interacts with something already running, that the kidney function makes the usual dose wrong, or that a documented allergy rules out the obvious choice. You get those answers only when you know to ask each question separately, and prescribing errors cluster where nobody thought to ask.

That is the step Prescriber.io is built for. You enter the drug and the patient's scenario once, and one card returns interactions across the whole list, contraindications, allergy blockers, renal and hepatic dose adjustments and alternatives, each with a cited source, for you to review and sign. It sits next to Harriet Lane rather than replacing it, and it is priced per clinician on our pricing page. If you are still choosing the rest of your reference stack, our best drug reference app guide compares the paid and free options role by role, and Epocrates vs Lexicomp covers the two general drug apps residents ask about most.