High-Cost Generic Drugs — Implications for Patients and Policymakers — NEJM

High-Cost Generic Drugs — Implications for Patients and Policymakers — NEJM.

Excerpt

It is well known that new brand-name drugs are often expensive, but U.S. health care is also witnessing a lesser-known but growing and seemingly paradoxical phenomenon: certain older drugs, many of which are generic and not protected by patents or market exclusivity, are now also extremely expensive. Take the case of albendazole, a broad-spectrum antiparasitic medication. Albendazole was first marketed by a corporate predecessor to GlaxoSmithKline (GSK) outside the United States in 1982 and was approved by the Food and Drug Administration (FDA) in 1996. Its patents have long since expired, but no manufacturer ever sought FDA approval for a generic version. One reason may be that the primary indications for the drug — intestinal parasites, neurocysticercosis, and hydatid disease — occur relatively rarely in the United States and usually only in disadvantaged populations such as immigrants and refugees. In late 2010, the listed average wholesale price (AWP) for albendazole was $5.92 per typical daily dose in the United States and less than $1 per typical daily dose overseas.

….

 

Meanwhile, there is little that individual consumers can do. Some drug companies, such as Amedra, offer assistance programs for indigent patients, but these programs often have complicated enrollment processes, and they do not offer an effective general safety net.5 Some patients instead seek to acquire these drugs in other countries, since many of them are widely and inexpensively available outside the United States, but such foreign sources may be of variable quality. Until regulatory and market solutions are implemented to reduce prices for these older drugs, patients requiring such drugs and the physicians treating them will continue to be faced with difficult choices.

Related articles

• Generic drug competition and pricing nightmares

[News item] Canada paying more than double for common generic drugs, study says | Metro

Canada paying more than double for common generic drugs, study says | Metro.

From the 14 October article

Canada is paying more than double for six commonly used generic drugs compared with other developed countries because of a “highly unusual” purchasing plan, according to a new study released Tuesday.

Researchers found that through a mix of negotiations with drug companies and calls for tender, countries such as New Zealand, the United Kingdom and Germany are paying less than Canada for generic medications that treat everything from high blood pressure to depression. It’s all thanks to a model the author of the study, Amir Attaran, calls “a uniquely Canadian stupidity.”

The model implemented by the provinces and territories (except for Quebec) in April 2013 simply sets the price for the six generic drugs at 18 per cent of the price of the brand-name versions. At the time, the premiers, under the auspices of the Council of the Federation, said the six drugs represented 20 per cent of publicly funded spending on generic drugs and that the new spending plan was expected to save up to $100 million.

Related:

• Off-label prescribing by Canadian doctors raises concern
• Plain packaging for tobacco products a ‘logical next step,’ says cancer society
• Food fights back: London researchers tap yogurt as toxin defender

“The Canadian approach of setting a single price ceiling for multiple medicines is highly unusual,” says the study. “All other countries studied here have preferred competition or negotiation to varying extents.”

………..

Related articles

• Generic drugs overpaid for by provinces, study finds
• Canadians paying more for generic drugs
• Canadians paying more than double for certain generic drugs: Study
• Generic drugs cost more in Canada: Study

The wacky world of prescription prior authorizations

English: National Naval Medical Center, Bethesda, Md., (Aug. 19, 2003) — Pharmacist Randal Heller, right, verifies the dosage and medication of a prescription at the National Naval Medical Center in Bethesda, Maryland. Heller checks all prescriptions dispensed at the pharmacy before they are handed over the counter to the patient. Heller is retired as a Commander from the Navy Medical Service Corps. U.S. Navy photo by Chief Warrant Officer 4 Seth Rossman. (RELEASED) (Photo credit: Wikipedia)

Pharmacists are among my favorite professionals.
I’ve always been able to get expert prescription drug related information (as side effects) and OTC advice for free! Even when I wasn’t their customer.

But even they are human and have their customer service pet peeves.
Don’t we all who work with clients, customer, and “the public”.
(Just hope I’m not one of those wacky customers!).

 

From the 26 July 2013 KevinMD article

LUCY HORNSTEIN, MD | MEDS | JULY 26, 2013

It’s happened at last: the epitome of ridiculousness in the already pretty ridiculous world of drug prior authorizations. I wish I could say that I made this up.

I got a fax from a pharmacy requesting a prior authorization for a brand name drug called Protonix, one of a family of medications used to treat ulcers, acid reflux, and other forms of tummy ache. This happens. Because there are five different drugs in this class (not counting generics), there is no way I can keep straight which plans prefer which drug. Sadly, switching patients from one medication to another, even if it’s working just fine, purely because of which drug maker is in bed with which insurance plan, is an everyday event. No big deal.

Here’s the thing: the patient was already doing well on pantoprazole, which happens to be generic Protonix. What?

The fax from the pharmacy has more information: “The patient wants a prescription for brand name Protonix because she has a coupon that will allow her to pay only $4.00 for it.”

It just so happens that pantoprazole is already on the list of $4.00 generics!

But, says the pharmacy, that’s what the patient wants.

Read the entire article here

Related articles

• Prior Auths Gone Wild (dinosaurmusings.wordpress.com)
• Q&A with a pharmacist about generic substitution (smallbizadvisor.ca)
• Pharmacy With Success Generic Over The Counter London (diablo3pvparena.com)
• Should Inmates Bring Their Own Prescriptions to the Jail? (jailmedicine.com)

Focus on Active Ingredients – Not Brands

Easy to do! Sometimes, tho’ it might take a magnifying glass to read the fine print. But well worth the effort.

2020health's Blog

Guest blog post by Sandy Getzky, associate editor at ProveMyMeds, a public health and education startup focused on producing helpful resources concerning the treatment of common ailments. 

I work for a startup called: ProveMyMeds. And when I tell people this they usually assume we are some “Big Pharma” subsidiary tasked with proving the effectiveness of certain drugs. Not quite. We exist for the simple purpose of exposing the science of products and looking past brands and marketing. Let me explain with an example:

Which of these four sports drinks would you choose after your workout?

1. Dihydrogen Monoxide. A research-based beverage containing ingredients scientifically proven to help your body transfer its internal healing nutrients to muscles and systems that need rebuilding.
2. Aqua Fria. When you’re hot after a workout, Agua Fria cools you down and helps you feel better.
3. Eau d’Vie. Working out isn’t just about building strength and…

View original post 425 more words