When blockbuster drugs lose their patent protection, state Medicaid programs can save millions of dollars by switching patients to cheaper, generic versions of the medications. But prescription policies vary across the country, with some states mandating that generic drugs be substituted whenever possible while others require that patients give their consent before changing from a brand-name drug to its generic equivalent.
A new study tracking these policies concludes that some states, including Massachusetts, are quicker than others to bring down the costs of prescription drugs once alternatives are available. The difference has implications for expanding Medicaid coverage to more people after the national health care overhaul takes effect. At about the same time, three of the most commonly prescribed drugs -- Lipitor for high cholesterol, Plavix for blood clots, and Zyprexa for schizophrenia -- and their prices will also fall off the patent cliff.
In the study appearing in this month’s Health Affairs, Dr. William Shrank of Brigham and Women’s Hospital led a team from Harvard, Mount Sinai School of Medicine, and pharmacy company CVS Caremark that looked at what happened when the patent for Zocor expired in 2006 and generic versions of the cholesterol-lowering statin became available. In states that did not require patient consent for substituting simvastatin for Zocor, 98 percent of prescriptions were filled with the generic drug. In states that did require patient consent, less than one-third of the prescriptions were filled with the generic drug.
Medicaid programs nationally could have saved $19.8 million dollars if they all had generic-substitution policies that did not need patient consent, the authors conclude. Once Lipitor, Plavix, and Zyprexa go off patent in the next few years, the savings could total $100 million nationwide for Medicaid programs if policies did not require patient consent, the authors estimate.
“Generic medications for chronic diseases are as cost effective as any intervention we have in health care,” Dr. Troyen Brennan, executive vice president and chief medical officer of CVS Caremark said in an interview. The study was funded by a grant from CVS Caremark as part of a research collaboration with Harvard and Brigham and Women’s Hospital using pharmacy claims data to study medication use.
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|White Coat Notes covers the latest from the health care industry, hospitals, doctors offices, labs, insurers, and the corridors of government. Chelsea Conaboy previously covered health care for The Philadelphia Inquirer. Write her at firstname.lastname@example.org. Follow her on Twitter: @cconaboy.|
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