Cross-Sectional Analysis of Out-of-Pocket Payments for Commonly Prescribed Generic Medications Versus Discount Card Pricing

Letters5 September 2023Cross-Sectional Analysis of Out-of-Pocket Payments for Commonly Prescribed Generic Medications Versus Discount Card PricingPranav M. Patel, PharmD, MS, Jenna Len, PharmD, MBA, Shaina Shah, PharmD, MBA, Varun Vaidya, PhDPranav M. Patel, PharmD, MSUniversity of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, Ohio, Jenna Len, PharmD, MBAUniversity of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, Ohio, Shaina Shah, PharmD, MBAUniversity of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, Ohio, Varun Vaidya, PhDUniversity of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, OhioAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-0644 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Studies have found that bypassing insurer-adjudicated processes can reduce out-of-pocket (OOP) costs and overall drug spending (1–3). "Self-pay" pharmacy prices (for example, $4 generic list, Costco member price) can be competitive, especially for generic medications, and in certain cases lower than OOP costs determined by the insurer (1–3). Discount card programs are another avenue to potentially lower OOP costs, especially for a subgroup of patients—uninsured, underinsured, or individuals enrolled in high-deductible health plans.Objective: To estimate the proportion and extent of OOP payments exceeding Amazon Prime and GoodRx Gold discount card pricing (called "excess OOP payment") for commonly prescribed ...References1. Trish E, Gascue L, Ribero R, et al. Comparison of spending on common generic drugs by Medicare vs Costco members. JAMA Intern Med. 2021;181:1414-1416. [PMID: 34228050] doi:10.1001/jamainternmed.2021.3366 CrossrefMedlineGoogle Scholar2. Lalani HS, Kesselheim AS, Rome BN. Potential Medicare Part D savings on generic drugs from the Mark Cuban Cost Plus Drug Company. Ann Intern Med. 2022;175:1053-1055. [PMID: 35724381] doi:10.7326/M22-0756 LinkGoogle Scholar3. Van Nuys K, Joyce G, Ribero R, et al. Frequency and magnitude of co-payments exceeding prescription drug costs. JAMA. 2018;319:1045-1047. [PMID: 29536088] doi:10.1001/jama.2018.0102 CrossrefMedlineGoogle Scholar4. Munigala S, Brandon M, Goff ZD, et al. Drug discount cards in an era of higher prescription drug prices: a retrospective population-based study. J Am Pharm Assoc (2003). 2019;59:804-808.e1. [PMID: 31422026] doi:10.1016/j.japh.2019.05.021 CrossrefMedlineGoogle Scholar5. Marcum ZA, Driessen J, Thorpe CT, et al. Effect of multiple pharmacy use on medication adherence and drug–drug interactions in older adults with Medicare Part D. J Am Geriatr Soc. 2014;62:244-252. [PMID: 24521363] doi:10.1111/jgs.12645 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Pranav M. Patel, PharmD, MS; Jenna Len, PharmD, MBA; Shaina Shah, PharmD, MBA; Varun Vaidya, PhDAffiliations: University of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, OhioDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-0644.Reproducible Research Statement: Study protocol: Not available. Statistical code: Not applicable. Data set: Available at https://meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-220A, https://www.amazon.com/primerx, and https://www.goodrx.com/gold.Corresponding Author: Pranav M. Patel, PharmD, MS, University of Toledo College of Pharmacy and Pharmaceutical Sciences, 3000 Arlington Avenue, Toledo, OH 43614; e-mail, Pranav.Patel@rockets.Utoledo.edu.This article was published at Annals.org on 5 September 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEvidence-Based Cardiovascular Disease Medicines' Availability in Low-Cost Generic Drug Programs in the United States Ivy T. Ton , Jungyeon Moon , Anthony Sengul , Freny Vaghaiwalla Mody , Towhid Rahman , Janet K. Han , and Cynthia A. Jackevicius Metrics LatestKeywordsDrug policyDrugsInsuranceMedicarePatient advocacy ePublished: 5 September 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...