Medicare Beneficiary Out-of-Pocket Costs for Generic Cardiovascular Medications Available Through $4 Generic Drug Discount Programs
Authors: Patrick Liu, Sanket S. Dhruva, Nilay D. Shah, Joseph S. Ross
Journal: Annals of Internal Medicine (2018)

Letters4 December 2018Medicare Beneficiary Out-of-Pocket Costs for Generic Cardiovascular Medications Available Through $4 Generic Drug Discount ProgramsPatrick Liu, BA, Sanket S. Dhruva, MD, MHS, Nilay D. Shah, PhD, and Joseph S. Ross, MD, MHSPatrick Liu, BAYale School of Medicine, New Haven, Connecticut (P.L.)Search for more papers by this author, Sanket S. Dhruva, MD, MHSYale School of Medicine and Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut (S.S.D.)Search for more papers by this author, Nilay D. Shah, PhDMayo Clinic, Rochester, Minnesota (N.D.S.)Search for more papers by this author, and Joseph S. Ross, MD, MHSYale School of Medicine, Yale University School of Public Health, and Yale–New Haven Hospital, New Haven, Connecticut (J.S.R.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-0965 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Prescription drug spending in the United States totaled more than $328 billion in 2016 and continues to increase annually (1). To control expenditures, health plans are increasingly shifting costs to patients. Greater out-of-pocket expenses may adversely affect medication adherence and subsequent health outcomes (2). Generic drug discount programs (GDDPs), including one from Walmart, were started in 2006 and sell many commonly used generic medications for $4 per 30-day supply regardless of insurance status and may lead to patient savings (3, 4).Objective: To compare Medicare beneficiary out-of-pocket costs through prescription drug plans (PDPs) with $4 GDDP cash prices, focusing ...References1. Centers for Medicare & Medicaid Services. National health expenditure data: historical. 8 January 2018. Accessed at www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/Proj2017Tables.zip on 11 April 2018. Google Scholar2. Claxton G, Levitt L, Long M. Payments for cost sharing increasing rapidly over time. Kaiser Family Foundation Health Spending. 12 April 2016. Accessed at www.healthsystemtracker.org/brief/payments-for-cost-sharing-increasing-rapidly-over-time on 11 April 2018. Google Scholar3. Van Nuys K, Joyce G, Ribero R, Goldman DP. Frequency and magnitude of co-payments exceeding prescription drug costs. JAMA. 2018;319:1045-7. [PMID: 29536088] doi:10.1001/jama.2018.0102 CrossrefMedlineGoogle Scholar4. Zhang Y, Gellad WF, Zhou L, Lin YJ, Lave JR. Access to and use of $4 generic programs in Medicare. J Gen Intern Med. 2012;27:1251-7. [PMID: 22311333] doi:10.1007/s11606-012-1993-9 CrossrefMedlineGoogle Scholar5. Walmart. Retail prescription program drug list. 8 September 2017. Accessed at http://i.walmart.com/i/if/hmp/fusion/genericdruglist.pdf on 11 April 2018. Google Scholar Author, Article, and Disclosure InformationAffiliations: Yale School of Medicine, New Haven, Connecticut (P.L.)Yale School of Medicine and Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut (S.S.D.)Mayo Clinic, Rochester, Minnesota (N.D.S.)Yale School of Medicine, Yale University School of Public Health, and Yale–New Haven Hospital, New Haven, Connecticut (J.S.R.)Disclaimer: The authors assume full responsibility for the accuracy and completeness of the ideas presented, which do not represent the views of any supporting intuitions.Financial Support: Dr. Dhruva is supported by the Robert Wood Johnson Foundation Clinical Scholars Program and by the U.S. Department of Veterans Affairs.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0965.Reproducible Research Statement:Study protocol and statistical code: Available from Dr. Ross (e-mail, joseph.[email protected]edu). Data set: Available for purchase at www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/NonIdentifiableDataFiles/PrescriptionDrugPlanFormularyPharmacyNetworkandPricingInformationFiles.html.This article was published at Annals.org on 24 July 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMedicare Prescription Drug Plan Coverage of Hormone Therapies Used by Transgender IndividualsGeneric Drugs in the United States: Policies to Address Pricing and CompetitionGreater OOP costs with Medicare prescription drug plans 4 December 2018Volume 169, Issue 11Page: 817-819KeywordsDisclosureDrug adherenceDrugsHyperlipidemiaHypertensionInterquartile rangeIschemic strokeMedicareOutpatientsPharmacists ePublished: 24 July 2018 Issue Published: 4 December 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...