Generic medicines offer proven cost savings for America’s seniors and taxpayers, more than $2 trillion over the past 10 years alone. This is the result of robust head-to-head price competition under which multiple generic drug makers fight for market share based on dramatically lower prices.
When seniors with Medicare drug coverage are paying the full cost for their generic seizure or asthma medications, it’s concerning. When the share of patients who have paid the full cost for certain generic drugs increases by nearly 20 percentage points over three years, it’s alarming. And when the price that patients with insurance are paying is higher than the price charged by generic manufacturers, it’s a clear sign that something is broken in the Medicare drug program.
On May 23, 2022, the Association for Accessible Medicines and its Biosimilars Council urged the Federal Trade Commission (FTC) to investigate the competitive impact of pharmacy benefit managers (PBMs) and their various abusive behaviors that undermine patient access to safe, affordable pharmaceutical care.
WASHINGTON, D.C.
Each year, the Association for Accessible Medicines releases a savings report that highlights where and how generic and biosimilar drugs save the US health care system hundreds of billions of dollars - over $338 billion in 2021.
Recently, the Centers for Medicare & Medicaid Services (CMS) released the 2021-2030 National Health Expenditure (NHE) report, prepared by their Office of the Actuary. The report serves as the authoritative estimate of total U.S. health spending and provides important clues as to what is (and is not) driving health care costs.1
As policymakers seek to respond to concerns about high drug costs, a recent report may provide a path forward. The Medicare Payment Advisory Commission (MedPAC) provides independent expert advice to Congress on Medicare payment policies and in a recent report to Congress, it recommends key changes to the Part D program that could serve as a foundation for sustainable savings through generic and biosimilar adoption.
KC, 73, of Seattle, Wash., has worked as a journalist for most of her career. Years ago, on a birthday trip to Chicago, KC found herself in the emergency room with a diagnosis of “off the charts” high blood pressure. Her doctor prescribed a few generic medicines that help her manage her condition.
“It’s just not an issue for me anymore,” KC says. “I’m on Medicare, and when I pick up my prescriptions, it doesn’t cost me anything. That’s a pretty good deal.”
In 2020, safe, effective, FDA-approved generic and biosimilar prescription medicines generated $338 billion in savings for U.S. patients and the health care system as a whole. No matter what condition you treat with generics or biosimilars, you can take these medicines with confidence. Here are condition-specific examples.
Greg, 37, of Los Angeles, Cal., spends most of his time hiking, running and lifting weights, but his greatest passion in life is pizza. Not long ago, he made a bet with his wife that he could eat pizza and nothing but pizza for 45 days. As if that weren’t unusual enough, you should know that Greg has a history of ulcerative colitis.
Steroids were not controlling his condition, so his gastroenterologist put him on a biologic medication. After a while, his insurance plan recommended switching to a biosimilar—a safe, effective alternative to a brand-name biologic.