Requesting generic drugs could save Medicare program $1.7 billion
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By substituting branded drugs requested by prescribers for generic versions, Medicare could have saved $997 million and patients could have saved $161 million in 2017, according to research published in JAMA Network Open.
“Even with laws in place, requesting a brand-name drug happens way more frequently than it should,” Gerard Anderson, PhD, professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, said in a press release. “This dispensing pattern results in exponentially higher costs for both the Medicare Part D program and patients.”
Anderson and colleagues conducted a cross-sectional study to examine claims for multisource drugs that had more than 1,000 branded claims dispensed in Medicare Part D. The researchers used Medicare Prescription Drug Event data from a nationwide random sample of one-fifth of Medicare beneficiaries in 2017.
They found that of 169 million claims for 224 multisource drugs, 4.9% were dispensed with a branded product. Of these claims, 59.2% did not include a recorded reason for the decision for branded dispensing; 16.9% were made because of a prescriber request; and 13.5% were made because of a patient request.
Anderson and colleagues determined that if the branded drugs requested by prescribers were substituted with generics, the Medicare Part D program would have saved $997 million (56%), and patients would have saved $161 million (64.6%).
They also found that if branded drugs requested by patients were replaced with generics, the Medicare Part D program would save $673 million (53.4%), and patients themselves would save $109 million (55.1%), making the total savings to the Medicare Part D program $1.67 billion.
According to the researchers, the drugs that had the highest proportion of branded dispensing by request were generally high-cost drugs.
They noted that policies focused on lowering prescription drug spending should consider efforts to discourage prescribers and patients alike from asking for branded drugs.
“Patients should always be mindful of the extra costs for themselves and for taxpayers associated with requesting a brand-name prescription drug,” Ge Bai, PhD, CPA, associate professor at the Johns Hopkins Carey Business School and in the Bloomberg School’s Department of Health Policy and Management, said in a press release. “Prescribing clinicians can also play an important role in educating their patients on the safety and effectiveness of generic drugs.”
References:
Socal MP, et al. JAMA Netw Open. 2021;doi:10.1001/jamanetworkopen.2021.0483.
Newswise. Requests for Brand Name Over Generic Prescription Drugs Cost the Medicare Program $1.7 Billion in a Single Year, Study Finds. https://www.newswise.com/articles/requests-for-brand-name-over-generic-prescription-drugs-cost-the-medicare-program-1-7-billion-in-a-single-year-study-finds. Accessed March 2, 2021.