The Association between Industry Payments and Brand-Name Prescriptions in Otolaryngologists

2019 ◽  
Vol 161 (4) ◽  
pp. 605-612 ◽  
Author(s):  
Elliot Morse ◽  
Jonathan Hanna ◽  
Saral Mehra
Keyword(s):  
Drug Prescription ◽  
Medicare Part D ◽  
Medicare Part ◽  
Brand Name ◽  
Part D ◽  
Individual Physician ◽  
Kendall’S Τ ◽  
The Individual ◽  
Dollar Amount ◽  
Brand Name Drugs

Objective To associate pharmaceutical industry payments to brand-name prescriptions by otolaryngologists. Study Design Retrospective cross-sectional analysis. Setting Open Payments Database and the Medicare Part D Participant User File 2013-2016. Subjects and Methods We identified otolaryngologists receiving nonresearch industry payments and prescribing to Medicare Part D recipients. Records were linked by physician name and state. The value of industry payments and the percentage of brand-name drugs prescribed per hospital referral region (HRR) were characterized as medians. Industry payments were correlated to the rate of brand-name prescription by Kendall’s τ correlation. This was repeated at the individual physician level and stratified by payment type. Results In total, 8167 otolaryngologists received a median of $434 (interquartile range, $138-$1278) in industry compensation over 11 (3-26) payments. Brand-name drugs made up a median of 12.9% (8.6%-18-4%) of each physician’s drug claims. The number (τ = 0.05, P < .001) and dollar amount (τ = 0.04, P < .001) of industry payments were correlated with the rate of brand-name drug prescription at the individual physician level. The number of industry payments was also associated with the rate of brand-name prescription by HRR (τ = 0.14, P < .001), but the dollar amount was not. By HRR, food and beverage payments received by physicians were associated with the rate of brand-name drug prescription (τ = 0.04, P < .001), but travel and lodging payments were not. Conclusions Industry financial transactions are associated with brand-name drug prescriptions in otolaryngologists, and these associations are stronger at the regional level than at the individual physician level. These correlations are of modest strength and should be interpreted cautiously by readers.

Medicare Part D Plans Rarely Cover Brand-Name Drugs When Generics Are Available

2020 ◽  
Vol 39 (8) ◽  
pp. 1326-1333
Author(s):  
Stacie B. Dusetzina ◽  
Juliette Cubanski ◽  
Leonce Nshuti ◽  
Sarah True ◽  
Jack Hoadley ◽  
...  
Keyword(s):  
Medicare Part D ◽  
Medicare Part ◽  
Brand Name ◽  
Part D ◽  
Brand Name Drugs

scholarly journals Medicare Part D: Patients Bear The Cost Of ‘Me Too’ Brand-Name Drugs

2016 ◽  
Vol 35 (7) ◽  
pp. 1237-1240 ◽  
Author(s):  
Nicole M. Gastala ◽  
Peter Wingrove ◽  
Anne Gaglioti ◽  
Stephen Petterson ◽  
Andrew Bazemore
Keyword(s):  
Medicare Part D ◽  
Medicare Part ◽  
Brand Name ◽  
Part D ◽  
The Cost ◽  
Brand Name Drugs

scholarly journals Projected spending for brand-name drugs in English primary care given US prices: a cross-sectional study

2020 ◽  
Vol 113 (9) ◽  
pp. 350-359
Author(s):  
Michael Liu ◽  
Brian MacKenna ◽  
William B Feldman ◽  
Alex J Walker ◽  
Jerry Avorn ◽  
...  
Keyword(s):  
Primary Care ◽  
Medicare Part D ◽  
Access To Medicines ◽  
Cross Sectional Study ◽  
Medicare Part ◽  
Brand Name ◽  
Cross Sectional ◽  
Part D ◽  
The Us ◽  
Brand Name Drugs

Summary Objectives To estimate additional spending if NHS England paid the same prices as US Medicare Part D for the 50 single-source brand-name drugs with the highest expenditure in English primary care in 2018. Design Retrospective analysis of 2018 drug prescribing and spending in the NHS England prescribing data and the Medicare Part D Drug Spending Dashboard and Data. We examined the 50 costliest drugs in English primary care available as brand-name-only in the US and England. We performed cost projections of NHS England spending with US Medicare Part D prices. We estimated average 2018 US rebates as 1 minus the quotient of net divided by gross Medicare Part D spending. Setting England and US Participants NHS England and US Medicare systems Main outcome measures Total spending, prescriptions and claims in NHS England and Medicare Part D. All spending and cost measures were reported in 2018 British pounds. Results NHS England spent £1.39 billion on drugs in the cohort. All drugs were more expensive under US Medicare Part D than NHS England. The US–England price ratios ranged from 1.3 to 9.9 (mean ratio 4.8). Accounting for prescribing volume, if NHS England had paid US Medicare Part D prices after adjusting for estimated US rebates, it would have spent 4.6 times as much in 2018 on drugs in the cohort (£6.42 billion). Conclusions Spending by NHS England would be substantially higher if it paid US Medicare Part D prices. This could result in decreased access to medicines and other health services.

scholarly journals Industry Payments to Physicians and Prescriptions of Brand-Name Proton-Pump Inhibitors

2018 ◽  
Vol 160 (1) ◽  
pp. 70-76 ◽  
Author(s):  
Elliot Morse ◽  
Rance J. T. Fujiwara ◽  
Saral Mehra
Keyword(s):  
Study Design ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Medicare Part D ◽  
Brand Name ◽  
Cross Sectional ◽  
Part D ◽  
Dollar Amount ◽  
Brand Name Drugs ◽  
Open Payments

Objective To characterize the association between industry payments and prescriptions of 2 brand-name proton-pump inhibitors (PPIs). Study Design Cross-sectional retrospective. Setting Physicians nationwide. Subjects and Methods We identified all physicians receiving industry payments for Dexilant and Nexium 2014-2015 from the Open Payments database. We linked this to records of prescriptions for PPIs paid for by Medicare Part D these same years and compared the proportion of prescriptions written for Dexilant and Nexium in industry-compensated vs nonindustry compensated physicians. The number and dollar amount of payments were associated with the rate of drug prescriptions. Results We identified 254,452 physicians prescribing PPIs; 8586 and 2766 physicians received industry payments for Dexilant and Nexium, respectively. A total of 5052 of 7876 (64%) physicians compensated for Dexilant prescribed Dexilant vs 39,778 of 246,571 (16%) noncompensated physicians ( P < .001). For Nexium, 2525 of 2654 (95%) compensated physicians prescribed Nexium, compared to 123,913 of 252,067 (49%) noncompensated physicians. For both Dexilant and Nexium, there was a significant correlation between the number (ρ = 0.22, P < .001 and ρ = 0.12, P < .001) and dollar amount (ρ = 0.22, P < .001 and ρ = 0.13, P < .001) of payments and the percentage of prescriptions written for the compensated drug. Industry payments for Nexium remained associated with rate of prescription even after generic esomeprazole became available. Conclusion Both the number and dollar amount of industry payments were associated with increased prescriptions for both Dexilant and Nexium. Although unable to show causality, this study suggests that industry payments may increase physician prescriptions of costly, brand-name drugs.

Spending and Utilization on Drugs Prescribed by Otolaryngologists to Medicare Beneficiaries, 2013 to 2017

2021 ◽  
pp. 000348942110504
Author(s):  
Shivani A. Shah ◽  
Lauren E. Miller ◽  
Roy Xiao ◽  
Alan Workman ◽  
Lucy Xu ◽  
...  
Keyword(s):  
Medicare Part D ◽  
Relative Increase ◽  
Medicare Part ◽  
Prescription Data ◽  
Annual Growth Rate ◽  
Medicare Beneficiaries ◽  
Brand Name ◽  
Part D ◽  
Relative Decrease ◽  
Brand Name Drugs

Objectives: The significant and rising cost of prescription drugs is a pressing concern for patients and payers. However, little is known about spending on and utilization of drugs prescribed by otolaryngologists. Methods: Utilizing publicly available Medicare Part D Prescriber Public Use data, we conducted a retrospective cross-sectional analysis of 34 small-molecule drugs commonly prescribed by otolaryngologists (defined as 2017 Medicare Part D spending ≥$500 000) to Medicare beneficiaries. Prescription data was characterized by drug type (brand name vs generic). Primary outcomes for each prescription drug included the total annual cost and the total annual number of days supplied. Results: From 2013 to 2017, spending on drugs prescribed by otolaryngologists to Medicare beneficiaries decreased by $32.1 million ($131.7–$99.5 million; relative decrease 24.4%; compound annual growth rate [CAGR] −5.4%), while total utilization increased by 24.9 million days supplied (74.6–99.5 million; relative increase 33.3%; CAGR 5.9%). For brand name drugs, there was a decrease in spending ($71.1–$26.7 million; relative decrease −62.4%; CAGR −17.8%) and utilization (11.2–3.1 million days supplied; relative decrease −72.5%; CAGR −22.8%). In contrast, generic drugs demonstrated increased spending ($60.6–$72.8 million; relative increase 20.2%; CAGR 3.7%) and utilization (63.5–96.4 million days supplied; relative increase 51.9%; CAGR 8.7%). Conclusions: Spending on drugs prescribed by otolaryngologists to Medicare Part D beneficiaries declined between 2013 and 2017 in part due to a transition from brand name drugs to lower-cost generic equivalents.

Patient and Payer Incentives to Use Patented Brand-Name Drugs vs Authorized Generic Drugs in Medicare Part D

2021 ◽  
Author(s):  
Stacie B. Dusetzina ◽  
Ameet Sarpatwari ◽  
Michael A. Carrier ◽  
Richard A. Hansen ◽  
Nancy L. Keating ◽  
...  
Keyword(s):  
Generic Drugs ◽  
Medicare Part D ◽  
Medicare Part ◽  
Brand Name ◽  
Part D ◽  
Brand Name Drugs

Closure of Medicare Part D coverage gap by the Affordable Care Act (ACA) and use of oral anti-myeloma agents.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6522-6522
Author(s):  
Adam J. Olszewski ◽  
Stacie Dusetzina ◽  
Amy J. Davidoff ◽  
Amal N Trivedi
Keyword(s):  
Low Income ◽  
Medicare Part D ◽  
Medicare Part ◽  
Brand Name ◽  
Difference In Differences ◽  
Part D ◽  
Coverage Gap ◽  
Catastrophic Coverage ◽  
Medicare Database ◽  
Brand Name Drugs

6522 Background: Medicare Part D pays for oral anti-myeloma immunomodulatory drugs (IMiDs, lenalidomide and thalidomide), but has a coverage gap resulting in an out-of-pocket (OOP) expense of > $ 3000 for the 1st prescription (Rx). Patients (pts) eligible for Low Income Subsidies (LIS) are exempt from cost sharing, and LIS is associated with IMiD receipt ( Olszewski, ASH 2016). In 2011, the ACA partly closed the coverage gap with a 50% manufacturer discount on the price of brand-name drugs within the gap. We examined effects of this policy on IMiD use. Methods: From the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we selected Part D enrollees who started anti-myeloma chemotherapy in 2008-2012. We identified IMiD use in periods pre-ACA (2008-10) and post-ACA (2011-12), among pts with or without LIS. After confirming parallel trends in IMiD use before the ACA, we examined the effect of ACA discount on IMiD use in a difference-in-differences (DiD) model, using LIS recipients as controls whose OOP costs were not influenced by the ACA. Results: Among 3,313 Part D enrollees (of whom 31% received LIS), 41% received IMiDs as part of their anti-myeloma regimen. Compared with the pre-ACA period, in the post-ACA period the median gross IMiD cost of the 1st Rx increased for all pts (Table). OOP costs for the 1st Rx, and for the 1st year of IMiD therapy, decreased for LIS non-recipients. Proportion of pts entering catastrophic coverage with their 1st IMiD Rx decreased from 71% to 49%. However, there was no statistically significant effect of the ACA discount on the proportion of pts treated with IMiDs (DiD estimator, 3% [95%CI, -4 to 10]; P=.40), or on the time from diagnosis to 1st Rx (median 1.5 mo. in all groups). Conclusions: The ACA-mandated partial closure of coverage gap lowered the OOP costs for Part D enrollees treated with IMiDs. As the median OOP cost remains > $2400 for the 1st Rx, and > $4900 for the 1st year of therapy, the policy may be insufficient to overcome the financial barrier for beneficiaries who do not receive the LIS. [Table: see text]

scholarly journals The role of county-level socioeconomic status on brand-name prescriptions in Medicare part D

Medicine ◽  
2020 ◽  
Vol 99 (9) ◽  
pp. e19271
Author(s):  
Connor Volpi ◽  
Fadi Shehadeh ◽  
Eleftherios Mylonakis
Keyword(s):  
Socioeconomic Status ◽  
Medicare Part D ◽  
Medicare Part ◽  
County Level ◽  
Brand Name ◽  
Part D
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