In 2017, generics accounted for 90% of prescriptions in the United States, and while brand name drugs accounted for just 10% of prescriptions, they were responsible for 77% of prescription spending.
As the nation grapples with ways to lower healthcare costs, access to generics plays a large role in saving patients, and the health system, money at the pharmacy counter. In 2017 alone, generics generated $265 billion in savings, according to a report from the Association for Accessible Medicines.
Savings for Medicare and Medicaid alone totaled $82.7 billion and $40.6 billion, respectively.
In 2017, generics accounted for 9 of every 10 prescriptions filled in the United States, and 93% of these prescriptions were filled at $20 or less. While brand name drugs accounted for just 10% of prescriptions, they were responsible for 77% of prescription spending. Due to high costs, those prescribed brand name drugs were 2 to 3 times more likely to not pick up their prescription after calling it in.
Looking by drug class, the biggest savings were seen in mental health, which saved $42 billion from generic drugs, followed by $34 billion for cholesterol and $31 billion for hypertension. By patient condition, savings totaled $48 billion for mental illness, $47 billion for heart disease, and $17 billion for epilepsy.
Savings by state averaged $5.2 billion, ranging from $354 million in Alaska to $23.2 billion in California.
In recent years, the gradual introduction of biosimilars to the market has provided another outlet for prescription cost savings. In the 8 years since the passage of the Biologics Price Competition and Innovation Act (BPCIA), 12 biosimilars have been approved, most recently a second biosimilar to Amgen’s reference filgrastim (Neupogen), used to treat neutropenia.
With biologics often coming with hefty price tags, “biosimilars have the potential to improve the quality of life for American patients while at the same time saving the health system billions of dollars each year—provided that the right policies are in place to nurture a robust marketplace,” states the report.
However, despite 12 FDA approvals, just 4 biosimilars have entered the US market, as others are tied up in pending litigation. Under the BPCIA, drug innovators are provided 12 years of market exclusivity to make up for research and development costs. And even when that 12-year period has ended, biosimilars still have hurdles to climb.
The report gave the example of adalimumab (Humira), used to treat rheumatoid arthritis and Crohn disease, which comes with a list price of $38,000. Despite its primary patent being expired, the 2 FDA-approved biosimilars to the drug are being blocked from entering the market through the patent process. In the meantime, the price of the reference Humira continues to rise, increasing 122% over the past 5 years.
To learn more about biosimilars, visit The Center for Biosimilars®, a sister site of The American Journal of Managed Care®.
Overcoming Employment Barriers for Lasting Social Impact: Freedom House 2.0 and Pathways to Work
April 16th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our second episode, in which we learn all about Freedom House 2.0 and the Pathways to Work program.
Listen
An Overview of Health Care and Pharmaceutical Trends, 2023-2024
April 19th 2024Douglas M. Long, BA, MBA, was featured as the keynote speaker on the closing day of The Academy of Managed Care Pharmacy 2024 annual meeting, with a session dedicated to surveying the health care and pharmaceutical trends of the last year.
Read More
Making Giant Strides in Maternity Health Through Baby Steps
April 9th 2024To help celebrate and recognize National Minority Health Month, we are kicking off a special month-long podcast series with our strategic alliance partner, UPMC Health Plan. Welcome to our first episode, which is all about the Baby Steps Maternity Program and its mission to support women throughout every step of their pregnancy journey.
Listen
Government agencies have created an online portal for the public to report potential anticompetitive practices in health care; there are changes coming to the “boxed warning” section for chimeric antigen receptor T-cell therapies (CAR T) to highlight T-cell blood cancer risk; questions about the safety of obesity medications during pregnancy have arisen in women on them who previously struggled with fertility issues.
Read More