Requests for brand name drugs over generics cost Medicare $1.7B in one year: study

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Prescribing clinicians and patients under the Medicare Part D program requested brand name prescription drugs over generics 30 percent of the time when a brand name drug was dispensed in 2017, and such choices are costing Medicare billions, according to a study published March 2 in JAMA Network Open.

Researchers analyzed Medicare Part D prescription drug claims from 2017, drawing on a random sample representing 20 percent of Medicare beneficiaries and 224 drugs that had a generic substitute and at least 1,000 claims. 

Their analysis found that the Medicare Part D program would have saved $977 million in 2017 if all branded prescription drugs requested by clinicians had been swapped with its generic substitute, and it would have saved an additional $673 million if all branded drugs requested by Medicare patients were swapped with a generic option, making for a total savings of $1.7 billion.

Of the 169 million filled prescriptions the research team analyzed, 8.5 million involved dispensing a brand name drug when a generic was available. Seventeen percent of those claims involved the clinician requesting a brand name drug over a generic, and 13.5 percent involved patients' requests.

The study also found Medicare patients would have saved $270 million in 2017 if the dispensed brand name drugs with available generics were replaced with their generic option.

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