Generic drugs ‘wildly overpriced’ in Medicare, study finds

DATE: July 15, 2019

Becker’s Hospital Review Morgan Haefner – Monday, July 15th, 2019

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.