New Report Shows the Extent to Which Plans and PBMs Delay Patient Access to Lower-Cost Generics
WASHINGTON, DC (January 23, 2023) — The Association for Accessible Medicines (AAM) today released a new report showing that drug supply chain middlemen like health plans and pharmacy benefit managers (PBMs) increasingly block patient access, delaying coverage of new generics in favor of higher-priced brand drugs with high rebates.
Patients and the health care system win when new, lower-cost generic drugs enter the market, said David Gaugh, AAM’s Interim CEO.
But too many PBM and health plan formularies are delaying patient access to new generic drugs.
Commercial and Medicare drug plans play a key role in determining which medicines patients can obtain. Unfortunately, too many continue to prefer high-price, high-rebate brand drugs and use their consolidated market power to block patient access to lower-priced generics and biosimilars, said Craig Burton, Senior Vice President, Policy & Strategic Alliances, AAM and Executive Director, Biosimilars Council.
Policymakers should ensure rapid patient access to new lower-price generics and biosimilar medicines.
Director of Communications, AAM
AAM is driven by the belief that access to safe, quality, effective medicine has a tremendous impact on a person’s life and the world around them. Generic and biosimilar medicines improve people’s lives, improving society and the economy in turn. AAM represents the manufacturers and distributors of finished generic pharmaceuticals and biosimilars, manufacturers and distributors of bulk pharmaceutical chemicals, and suppliers of other goods and services to the generic industry. Generic pharmaceuticals are 91 percent of prescriptions dispensed in the U.S. but only 18 percent of total drug spending.
About the Biosimilars Council
The Biosimilars Council, a division of the Association for Accessible Medicines (AAM), works to ensure a positive environment for patient access to biosimilar medicines. The Biosimilars Council is a leading source for information about the safety and efficacy of more affordable alternatives to costly brand biologic medicines. Areas of focus include public and health expert education, strategic partnerships, government affairs, legal affairs and regulatory policy. More information is available at www.biosimilarscouncil.org.