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

ABSTRACT: Recent press reports and other evidence suggest that Medicare Part D plans may be encouraging the use of brand-name drugs instead of generics. However, the scope of such practices is unclear. We examined Medicare Part D formulary coverage and tier placement of matched pairs of brand-name drugs and generics to quantify how often preferred formulary placement of brand-name drugs is occurring within and across Part D plans and to assess the cost implications for Medicare and its beneficiaries. We found that in 2019, 84 percent of 4,176,772 Part D plan-product combinations had generic-only coverage (that is, the brand-name counterparts were not covered). Another 15 percent covered both the brand-name and generic versions of a product. For the small number of products whose brand-name versions

SUBMITTER: Dusetzina SB 

PROVIDER: S-EPMC9297534 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature