Multiple Generics Required To Drive Down Price of Brand Name Drugs

MedicalResearch.com Interview with:

Jing Luo, MD, MPH Program on Regulation, Therapeutics, and Law (PORTAL) Division of Pharmacoepidemiology and Pharmacoeconomics Department of Medicine Brigham and Women’s Hospital and Harvard Medical School Boston, Massachusetts

Dr. Jing Luo

Jing Luo, MD, MPH
Program on Regulation, Therapeutics, and Law (PORTAL)
Division of Pharmacoepidemiology and Pharmacoeconomics
Department of Medicine
Brigham and Women’s Hospital and Harvard Medical School
Boston, Massachusetts

MedicalResearch.com: What is the background for this study? 

Response: Until recently, the cholesterol lowering drug atorvastatin was the highest selling prescription medication of all time. It’s transition in the prescription drug marketplace from being only available as a costly brand-name only product to one that incorporated healthy generic competition was delayed for many reasons. Generic competition has been shown to reduce prescription drug prices and improve adherence. However, for generic competition to work effectively, multiple competing generic are often required.

MedicalResearch.com: What are the main findings?

Response: In this study, we examined the effect of varying degrees of generic competition on brand-name atorvastatin use and on out-of-pocket spending for prescription drugs among patients with commercial health insurance. We found that limited generic competition through 1 competitor only reduced brand-name atorvastatin use by a modest amount, whereas full generic competition reduced brand-name atorvastatin use more substantially. We also found that out-of-pocket spending was not different comparing brand-name and generic products during the period of limited generic competition. Once full generic competition occurred, out-of-pocket spending by patients was substantially lower for generic formulations.

MedicalResearch.com: What should readers take away from your report?

Response: The effect of generic competition on prescription drug use or spending at the population level often depends on the number of generic competitors. A single generic manufacturer competing against a single brand-name manufacturer may not exert significant downward pressure on overall drug prices or drug spending.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: We hope to examine whether prescription drug adherence is different depending on whether a patient starts a brand-name or generic versions of atorvastatin.

MedicalResearch.com: Is there anything else you would like to add?

Response: Access to lower cost but equally effective prescription drugs may be one way to improve health outcomes in the United States. For chronic diseases like cardiovascular disease, adherence to evidence-based and proven therapies are unusually low. If prescription drug costs contribute to non-adherence, policy proposals should focus on reducing these costs in order to improve adherence and health outcomes.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Luo J, Seeger JD, Donneyong M, Gagne JJ, Avorn J, Kesselheim AS. Effect of Generic Competition on Atorvastatin Prescribing and Patients’ Out-of-Pocket Spending. JAMA Intern Med. Published online June 27, 2016. doi:10.1001/jamainternmed.2016.3384.

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