US Substitution Rates Lower For Higher Cost Brands
AAM-Sponsored Study Examines Medicare Part D
Study sponsored by Association for Accessible Medicines suggests quirks in Part D benefit design and rebating practices are driving the trend.
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An AAM-sponsored study by researcher Avalere Health has concluded that Medicare Part D policy changes have led to generics being placed on non-generic tiers 53% of the time in 2020, with generics placed on the ‘preferred generic’ Tier 1 just 10% of the time.
DeRoyal’s DeBusk urges a focus on rebates, while Brookings' Ginsburg wants a focus on design, not savings per se, as MedPAC discusses restructuring the Part D design to better accommodate current market dynamics. Formal recommendations to Congress may be approved in the spring.
Medicare Part D program should place generics on tiers separate from brand drugs and create a dedicated tier for specialty generics and biosimilars, AAM advocates in white paper.