Generic drugs ‘wildly overpriced’ in Medicare, study finds
Becker’s Hospital Review –
Many generic drugs in Medicare Part D are “wildly overpriced,” according to an analysis from drug pricing research firm 46brooklyn.
The report, which examined data from CMS’ Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files, found that while some generic drugs are priced fairly, others “show unbelievable pricing variations across Part D plans.”
Three things to know:
1. Researchers found in the first quarter of 2019, for example, that Medicare Part D sponsors priced generic mental disorder drug aripiprazole — brand name Abilify — anywhere from less than $0.30 per pill to more than $22 per pill.
2. In addition to being overpriced, many generic drugs are “over-tiered,” the researchers found. This means generic drugs that are usually less expensive are being assigned higher, often arbitrary prices. They are then placed in tiers used for more expensive drugs. This results in beneficiaries paying more out of pocket to access the drugs.
3. According to the analysis, pricing did not vary much among brand-name drugs, which was not surprising to the researchers. Still, some of the charts they created show “cliffs” that may indicate plans are pricing brand drugs lower than list price.
To read the full report, click here.
Recent Posts
-
House Lawmakers Push Bipartisan IRA Fix To Boost LTC Pharmacy Pay
A bipartisan group of House lawmakers introduced legislation aimed at ensuring long-term care (LTC) pharmacies are paid an adequate supply fee to maintain patient access to prescription drugs for which prices are lowered through the Medicare drug price negotiation program, with the new maximum fair prices (MFPs) for the first group of selected drugs to take effect at the start of 2026.
-
Bill would fix drug-negotiation pricing flaw that undercuts LTC pharmacists’ viability
Lawmakers have proposed a supply fee to bolster long-term care pharmacies facing major revenue losses with the implementation of negotiated prices on 10 commonly prescribed medications Jan. 1.
The Preserving Patient Access to Long-Term Pharmacies Act establishes a $30 per Medicare Part D prescription in 2026 and 2027.
-
Rep. Van Duyne Introduces Bipartisan Legislation to Protect Seniors’ Access to Long-Term Care Pharmacies
Washington, D.C. – Representatives Beth Van Duyne (R-TX), Brad Schneider (D-IL), Buddy Carter (R-GA), Sharice Davids (D-KS), and Deborah Ross (D-NC) introduced H.R. 5031 Preserving Patient Access to Long-Term Care Pharmacies Act, bipartisan legislation to protect access to essential medications and pharmacy services for seniors and other long-term care (LTC) residents in nursing homes, assisted living, and similar […]
Stay in the Know
Get the latest news and updates on issues impacting the long-term pharmacy community.