Generic drugs make up about 85% of human prescription drugs in the United States, according to FDA. A study done last year by CVS Health and Brigham and Women’s Hospital found that new patients who started on a generic statin vs. brand-name drug for high cholesterol were more likely to be adherent and had an eight percent lower rate of the composite endpoint of cardiovascular events and death. The mean co-payment of the generic drug was $10 vs. $48 for a branded statin. The study concluded that cost was a strong contributor to a patient’s willingness to remain adherent.
Because generics are much less expensive than their brand-name counterparts, many assume this would automatically translate into increased adherence. But, this isn’t always the case. Two factors that can derail the positive role generics play in adherence are manufacturing and insurance coverage.
Since various manufacturers produce generic drugs, the physical appearance of the pills may not resemble the brand-name drugs they replace. A different shape or color can result in confusion and concerns about safety and effectiveness of generic drug products. This, in turn, could lead to non-adherence. How serious an issue is this?
The government finds it critical enough to conduct a survey to get more information. The FDA is surveying 3,000 pharmacists and consumers to find out what the relationship is between the physical aspects of generic drugs and medication adherence rates. They will then use that information to guide regulatory policy and pharmacy business practices.
Pricing and Insurance Coverage
The helpful role generics play in increasing adherence may become stifled as generics’ pricing rises. Many, including those on Capitol Hill, are concerned that as costs increase, patients may stop getting their prescriptions filled or take less than prescribed.
Insurers’ reactions to the rising costs of generics vary. Some have instituted generic tiers and preferred lists that could jump a generic’s copay from $5 to $20. Others are capping copays for generics. HealthSpan in Ohio, Indiana and Kentucky is charging either a $4, $6 or $8 copay in order to ensure that members can afford their medications. However, there are those such as Blue Cross and Blue Shield of Kansas who state that the cost of generics are still lower than brand-name drugs and are doing nothing.
Whether using generic drugs increases adherence is still up for debate. If you’re involved in activities such as discharge planning and medication reconciliation, there are things you can do to help the patient remain adherent.
It’s important to inform patients that the generic pills may not look the same as what they’re used to but are still safe and effective. Also, the patients need to be comfortable talking to their doctors if pricing makes it impossible for them to take their medications as prescribed.
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