Utilization of Generic Cardiovascular Drugs in Medicare’s Part D Program

Background: Generic medications cost less than brand-name medications and are similarly effective, but brand-name medications are still prescribed. We evaluated patterns in generic cardiovascular medication fills and estimated the potential cost savings with increased substitution of generic for brand-name medications. Methods: This was a cross-sectional study of cardiovascular therapies using the Medicare Part D database of prescription medications in 2017. We evaluated drug fill patterns for therapies with available brand-name and generic options. We determined the generic substitution ratio and estimated the potential savings with increased generic substitution at the national, state, and clinician level. We compared states with laws related to mandatory pharmacist generic substitution and patient consent for substitution. Results: Of ≈$22.9 billion spent on cardiovascular drugs in Medicare Part D prescription programs in 2017, ≈$11.0 billion was spent on medications with both brand-name and generic options. Although only 2.4% of medication fills were for the brand-name choice, they made up 21.2% of total spending. Accounting for estimated brand-name rebates, generic substitution for these medications would save $641 million, including $135 million in costs shouldered by patients. Furthermore, the minority of clinicians with the lowest generic utilization was responsible for a large proportion of the potential cost savings. Conclusions: There are substantial potential cost savings from substituting brand-name medications with generic medications. These savings would be primarily driven by lower use of brand-name therapies by the minority of clinicians who prescribe them at increased rates.

Social Injustice by Prescription?

Since independence, Tanzania has instituted healthcare reforms in the quest for improving availability, quality, and social equity in access to public medical services. The extent to which the most recent healthcare reforms have impacted the existing patterns of medicinal prescription writing is largely opaque in the literature. This paper relies on data from two hospitals in Dar es Salaam. It emerges that the practice of categorising healthcare seekers into groups depending upon their varied health status and their entitlement to benefits has resulted in differential prescription allocations that might be interpreted as inequitable. The majority of very low income patients finance their healthcare through out-of-pocket payments and support of the Community Health Fund; this group receives a greater ratio of services with zero prescriptions, less poly-pharmacy and fewer prescribed generic medications than the proportion received by well-to-do patients with healthcare insurance. However, the medical and non-medical determinants of this differential in prescription allocation remain unclear, and so too, the ethical implications of such patterns in Tanzania’s out-patient medical service system are inconclusive.

TP8.2.18 Every little helps. A trainee led cost saving initiative

Aim The NHS is under pressure to deliver the best quality care within a confined budget. The cost of spending on medications is growing by 12% per annum. The five year forward plan for the NHS called for £22 Billion in efficiency savings. All NHS staff are being asked to help deliver better outcomes at lower costs. We aimed to review costs in the surgical department, identify savings, implement changes and evaluate the outcome. Method Pharmacy orders from 2016-17 were reviewed. Prices of branded and generic medications were compared. Levobupivicaine was identified as a product with cost savings between branded and generic forms. Procurement officers were advised to switch to generic alternatives and the pharmacy system was adjusted to highlight that generic forms should be ordered. Orders for 2018-19 were reviewed and savings calculated. Results 29,280 units of levobupivicaine were ordered in 2016-17. 100% of these orders were of the branded product. Projected savings of switching to a generic product was £12,846 per annum. 31,355 units of levobupivicaine were purchased during the 2018-19 period. 83% of orders were for the generic product. £11,805 was saved over this period. £1,703 of further savings have been highlighted. Conclusion We have shown that simple changes can result in modest savings. All NHS staff, including trainees, can lead cost reducing initiatives. Multiple small savings will summate to larger savings, resulting in resources being better utilised to improve patient outcomes.

Authorized generics vs. branded generics: A perspective

Nowadays, there are many generic medications available in the market. Their sale is increasing day by day due to their lower cost and affordability by most of the customers. Generic medications are pharmaceuticals that are therapeutically equivalent to an original off patent drug. Both authorized generics and branded generics are the versions of generic medications. They offer lucrative business and increase competition for ordinary generics. They supply medications having quality of branded drugs at lower prices and this establishes their recognition among the masses who earlier has limited options to buy only brand-name drugs. They are cheaper than brand name drugs but costlier than ordinary generics. Authorized generics are sold only by Innovator Companies but the branded generics can be sold by both innovator companies and generic companies. They both are different from one another and have their own impact on the brand drug companies, generic companies and consumers.

GENERIC PRESCRIPTION IN INDIA – A REVIEW

In India, a Generic drug plays a major role where most of the people afford and depend on it, due to the budget-friendly and easily available widely. However, some of the pharmaceutical manufacturer’s license was terminated due to the unsold or banned products of branded drugs, which are manufactured in USFDA as small plants, were manufactured in India without the approval. There were many misconceptions with the manufacturers, for following the right strategy to bring generic medications, clearing data integrity issues, sales, and marketing aspects of drugs for the successful outcome. India has also been subject to increasing inspections by global regulatory bodies in recent times. There has been an increase in enforcement actions taken by regulatory bodies for cases related to data integrity. From this review, it concluded that what are the current trends involved in the generic drugs and their category based on the license, impact, and issues involved and also provides the recommendations to be followed to prevent further issues in the future.

The Use of Generic Medications for Glaucoma

The use of generic medicines has grown considerably in recent years providing considerable cost savings. In England, generic items represented 11.7% of prescriptions for glaucoma and ocular hypertension in 2009, increasing to 55.2% of prescriptions in 2018. Generics can be brought to the market quickly and at low cost as manufacturers are not required to repeat animal or clinical research on active ingredients already approved for safety and efficacy. Although there is no regulatory requirement for studies comparing branded and generic eye drops, several randomised crossover studies have been performed comparing branded and generic prostaglandin analogues. While most have shown similar intraocular pressure lowering, studies are of short duration and have not evaluated visual field endpoints. Furthermore, differences in inactive ingredients, pH, viscosity, levels of particulate matter, and degradation over time have been reported. Other potential problems with generic eye drops include differences in bottle design affecting adherence, problems with supply, and the possibility that reduced revenue for innovator companies will lead to reduced investment in new drug development. This article reviews the potential advantages and disadvantages of generic antiglaucoma medications.