Discounted diabetes drugs have benefits, drawbacks

ADA 71st Scientific Sessions

SAN DIEGO — Deep discounts on generic medications offered by “big-box” retailers, such as Wal-Mart and Kmart, may be a complicated solution to rising health care costs for patients with diabetes.

Endocrine Today Editorial Board member Ronald Tamler, MD, PhD, MBA, and colleagues investigated diabetes drug price developments since 2008. They posed as patients and requested prices for the 10 most prescribed medications for patients with diabetes, including seven generic and three brand name drugs. The study was an update to research previously presented at the American Diabetes Association’s 69th Scientific Sessions in 2009.

Results indicated that, overall, large discount outlets undercut the prices of generics offered by smaller stores and neighborhood pharmacies. A 30-day supply of all 10 medications costs $507.40 at Wal-Mart and $431.46 at the mail-order pharmacy Medco, whereas the price was $612.90 at CVS, the researchers reported. Nevertheless, prices for generics have dropped in general, with nearly all competitors coming close to the price offered by Wal-Mart, according to Tamler.

“Because [most retailers] have come down now, in terms of generic pricing, patients who are mostly using generic drugs can now focus on other, less quantifiable things, such as services and counseling, instead of the price difference in generic medicine,” Tamler, who is assistant professor in the division of endocrinology at Mount Sinai School of Medicine in New York, said in an interview.

He pointed out, however, pioneers of low-cost generics, Wal-Mart and Kmart, significantly increased prices for brand name drugs (32% and 35%, respectively) when compared with their competitors (21%).

“This is consistent with a loss-leader marketing strategy where you get the customer into the door with a cheap offer and then sell them other, sometimes more expensive, products,” Tamler said.

Patients with diabetes who take brand name medications are often most affected by the escalating drug prices. Because patients with diabetes are taking on average nine drugs per day, on average, many are looking for the best deals possible when purchasing their medications. While prices for generic drugs have become increasingly similar, savvy consumers may exploit the price difference for brand-name medications, which has more than doubled.

“Patients who are taking a lot of brand name medications may want to shop around,” Tamler said. “Physicians should be aware of the $4 generic formularies for uninsured and underinsured patients, but should also know that they come with a catch, and that the catch is, over time, the brand name prices may increase.” – by Melissa Foster

For more information:

• Lu K. 1177-P. Presented at: American Diabetes Association’s 71st Scientific Sessions; June 24-28, 2011; San Diego, Calif.

Disclosure: Dr. Tamler reports no relevant financial disclosures.

I currently work at a federally qualified health center taking care of the underinsured and uninsured. This abstract is quite interesting because [the issue] is prevalent in my patient population, which has limited access to pharmacy coverage, so the $4 inexpensive pharmacy products are useful for that population. It is nice to see that there are more options available as time goes on and that patients have choices between pharmacies, whereas before they were limited. There are a variety of medications available for them as well.

- Aileen Cannon, MD
Clinical Director, Internal Medicine Department
Ocean Health Initiatives
Lakewood, NJ

Disclosure: Dr. Cannon reports no relevant financial disclosures.

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