When economic times are difficult, people turn to cost-saving measures to stretch their money. When it comes to health care, Americans are delaying care or going for needed medical tests. Pharmacists across the country can share heartbreaking stories of patients skipping doses or cutting pills in half to make their medicines last longer. We all know that resorting to these measures harms patient health, but, sometimes, these patients feel they have no other choice.
Or do they? The fact is that countless Americans can save money while still receiving quality care by switching from brand drugs to generic medicines. Thankfully, millions of Americans already know this, which is why 65% of prescriptions are filled with generics. Barriers still exist, however, that keep generic medicines from coming to the marketplace in a timely fashion. Moreover, for those patients who are taking biopharmaceutical medicines for lifethreatening illnesses, such as heart disease and cancer, there are simply no generic alternatives available. Why? Congress has yet to pass an approval pathway for safe and affordable biogeneric medicines.
As the economic tide continues to spiral downward, Congress will be under considerable pressure to break down barriers to access generic medicines as well as pass biogenerics legislation in 2009. The need for congressional action is particularly critical for senior citizens, who often find they are taking multiple medications that wreak havoc on their limited financial budgets.
In the fall, AARP released the "Rx Watchdog Report: Trends in Manufacturing Prices of Specialty Prescription Drugs Used by Medicare Beneficiaries" study. The research offered dramatic evidence on why Congress needs to eliminate barriers to access and also give the FDA the authority to create a pathway for biogenerics to address escalating Medicare Part D prescription prices.
The report found that manufacturer prices for the specialty drug products most widely used by Medicare beneficiaries rose 7.9% in 2006 and 8.7% in 2007, nearly 3 times the national rate of inflation over the 2-year period. For an individual who takes a specialty prescription for a chronic condition, the average increase in the drug used to treat that condition rose by almost $5800 between 2004 and 2007.
Although single-source brand products accounted for over half (52.8%) of nonspecialty prescriptions dispensed through Medicare Part D, they consumed 89.8% of expenditures. This compares with generics, which represented 44.2% of the Part D nonspecialty prescriptions, but consumed just 6.2% of expenditures. Clearly, generics contribute to increased savings, access, and improved health care.
When it comes to biologics, the 31 biologics noted in the AARP report had an average daily cost of $93.24, amounting to >$34,032 per patient per year. The cost of a 1-year supply of Procrit (epoetin alfa) increased $27,000 during the study's 4-year period; Humira (adalimumab) increased $17,000; Levonox (enoxaparin sodium injection) by $9000. Without competition from biogeneric medicines, there can be no hope of relief for patients who need these and many other biologic products, and who have seen double-digit price increases, in some cases by >50%.
Increasing access to generics undoubtedly can help our nation's seniors obtain the medicines they need to lead healthy lives. A recent Medco study indicated that generic medicines can provide a "life jacket" to keep seniors from falling into the Medicare prescription drug doughnut hole. The study found that upon reaching the doughnut hole, Medicare beneficiaries increased their use of generics to 71%, and cut the use of branded drugs to 29%.
The study also found that Medicare beneficiaries prescribed statins are nearly twice as likely to abandon their medications when they reach the "coverage gap" than when the costs are covered. Furthermore, Medicare Part D recipients using branded statins were most at risk because they are more likely to stop taking their medications than those using a generic medicine.
In these trying economic times, it is critical that access to safe, effective, and affordable generics be strengthened. The generic pharmaceutical industry is committed to working with the new Congress and the new administration in helping seniors and all Americans receive greater access to generic and biogeneric medicines.
The Oncology Care Pharmacist in Health-System Pharmacy
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