|
 Generic drug co-payments in the U.S. exceeded the cost of medicines
about 28 percent of the time – or for more than one in four
prescriptions, researchers found.
Co-payments for branded drugs were higher than the medication cost
about 6 percent of the time, they report in JAMA.
“This is money that patients could be saving if they knew about and
could avoid the practice,” said lead study author Karen Van Nuys of
the Schaeffer Center for Health Policy and Economics at the
University of Southern California in Los Angeles.
While some people might not notice the overpayment because their
medicines cost only $5 or $10 with insurance, added costs at the
drugstore could make it even harder for some low-income patients to
afford their medicines and might lead them to skip doses, delay
refills or stop taking drugs altogether.
“Particularly for patients who struggle to afford their prescription
drugs, even modest savings would be helpful,” Van Nuys said by
email.
For the study, researchers examined 2013 data on the average prices
retail pharmacies get paid for filling prescriptions for people with
private health insurance as well as the co-payments, or
out-of-pocket fees, patients paid for their medicines.
Out of 9.5 million claims for prescription drugs, 2.2 million
involved overpayments, the study found.
Altogether, the overpayments totaled $135 million, or about $10.51
per person.
The average overpayment was $7.69. Overpayments exceeded $10 in
about 17 percent of claims.
For brand-name drugs, overpayments weren’t as common, but they were
higher on average at $13.46, compared with average overpayments of
$7.32 for generic drugs.
The most commonly prescribed drug, the painkiller hydrocodone with
acetaminophen, involved overpayment in one-third of cases, with an
average overpayment of $6.94.
[to top of second column] |
Twelve of the 20 most commonly prescribed drugs involved overpayment
rates above 33 percent.
Limitations of the study include the potential for pricing in 2013
to be different than what it would be today, the authors note.
It’s also important to recognize that using generic drugs can offer
patients effective treatments at lower costs than similar brand-name
alternatives, said Dr. Aaron Kesselheim, a researcher at Harvard
Medical School in Boston who wasn’t involved in the study.
While previous research has linked high drug costs to an increased
likelihood that poor people will stop taking medicines, the amount
of the overpayments found in the current study might not be large
enough to change patient behavior, Kesselheim said by email.
Cost-related non-adherence is usually more of an issue when there’s
a choice “between extremely inexpensive generic drugs and extremely
expensive brand-name drugs, not on average about $5 differences
between co-payments and negotiated reimbursement for generic drugs,”
Kesselheim said.
To avoid overpayments, patients should always ask the pharmacist if
their costs would be lower if they paid cash instead of using their
insurance, said Stacie Dusetzina, a health policy researcher at
Vanderbilt University Medical Center in Nashville, Tennessee.
“Pharmacists might not be allowed to offer this information to
patients due to `gag clauses’ but if patients ask, pharmacists can
tell them,” Dusetzina, who wasn’t involved in the study, said by
email.
“Several states have banned these practices and allow pharmacists to
offer this information but even if you live in one of those states,
you should ask,” Dusetzina added. “Patients can also use pricing
tools on the internet like GoodRx.com to see what prices they could
expect across a variety of pharmacies if they paid cash.”
SOURCE: http://bit.ly/2FAkrS1 JAMA, online March 13, 2018.
[© 2018 Thomson Reuters. All rights
reserved.] Copyright 2018 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
