Unlike most commercial prescription coverage, where a patient pays more for a name-brand and therefore may ask a doctor for the generic, Part D charges a flat rate regardless of the drug’s cost. So, while the name-brand isn’t costing patients, it’s certainly costing Medicare.
Take for example Plavix, which costs around $193 per prescription. Its generic, clopidogrel, has been available since 2012, and its cost can be half of the name-brand, or less.
Physicians and health systems should take note of the easy availability of this data. While we shouldn’t expect most patients to be rushing to check out their provider’s generic prescription rate, federal and state efforts to contain healthcare costs — as well as health systems’ efforts to take on risk — could mean this data will mean a lot more to providers’ pay and volumes in the years ahead.