California Pacific Medical Center, San Francisco, CA (I.M.).
Department of Health Policy, Stanford University School of Medicine, CA (R.L.T.).
Circ Cardiovasc Qual Outcomes. 2021 Dec;14(12):e007559. doi: 10.1161/CIRCOUTCOMES.120.007559. Epub 2021 Dec 9.
Generic medications cost less than brand-name medications and are similarly effective, but brand-name medications are still prescribed. We evaluated patterns in generic cardiovascular medication fills and estimated the potential cost savings with increased substitution of generic for brand-name medications.
This was a cross-sectional study of cardiovascular therapies using the Medicare Part D database of prescription medications in 2017. We evaluated drug fill patterns for therapies with available brand-name and generic options. We determined the generic substitution ratio and estimated the potential savings with increased generic substitution at the national, state, and clinician level. We compared states with laws related to mandatory pharmacist generic substitution and patient consent for substitution.
Of ≈$22.9 billion spent on cardiovascular drugs in Medicare Part D prescription programs in 2017, ≈$11.0 billion was spent on medications with both brand-name and generic options. Although only 2.4% of medication fills were for the brand-name choice, they made up 21.2% of total spending. Accounting for estimated brand-name rebates, generic substitution for these medications would save $641 million, including $135 million in costs shouldered by patients. Furthermore, the minority of clinicians with the lowest generic utilization was responsible for a large proportion of the potential cost savings.
There are substantial potential cost savings from substituting brand-name medications with generic medications. These savings would be primarily driven by lower use of brand-name therapies by the minority of clinicians who prescribe them at increased rates.
仿制药的价格低于品牌药，且疗效相当，但品牌药仍在开。我们评估了仿制药心血管药物的使用模式，并估计增加仿制药替代品牌药可节省的潜在成本。
这是一项使用 2017 年医疗保险处方药物数据库的心血管治疗的横断面研究。我们评估了有品牌药和仿制药选择的治疗药物的药物使用模式。我们确定了仿制药替代率，并估计了在国家、州和临床医生层面增加仿制药替代的潜在节省。我们比较了有关于药剂师强制替代仿制药和患者替代同意的法律的州。
在 2017 年医疗保险处方计划中，约 229 亿美元用于心血管药物，其中约 110 亿美元用于有品牌药和仿制药选择的药物。尽管只有 2.4%的药物使用是品牌药选择，但它们占总支出的 21.2%。考虑到估计的品牌药回扣，如果用仿制药替代这些药物，将节省 6.41 亿美元，其中包括患者承担的 1.35 亿美元成本。此外，少数开处方率较高的医生对潜在成本节省的影响最大。
用仿制药替代品牌药可节省大量潜在成本。这些节省主要是由于少数开处方率较高的医生减少使用品牌药治疗而实现的。
