Published in:
01-06-2020 | Betaxolol | Concise Research Report
Medicare Formulary Coverage of Brand-Name Drugs and Therapeutically Interchangeable Generics
Authors:
Aishwarya Vijay, BS, Ravi Gupta, MD, Patrick Liu, BA, Sanket S. Dhruva, MD, MHS, Nilay D. Shah, PhD, Joseph S. Ross, MD, MHS
Published in:
Journal of General Internal Medicine
|
Issue 6/2020
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Excerpt
U.S. prescription drug sales, excluding physician-administered drugs, account for nearly 10% of total healthcare spending. Generic substitution is critical to curtailing prescription drug spending, but not all brand-name drugs have an approved bioequivalent generic. However, for many, therapeutically interchangeable generics are available, offering potential cost savings if substituted. The Center for Medicare & Medicaid Services (CMS) has proposed an indication-based formulary design starting in 2020,
1 allowing Medicare Advantage and Part D prescription drug plans to cover drugs only for select indications, which could increase formulary negotiating power and secure more competitive pricing. …
