PCMA Statement on New Avalere Study Examining Generic Drugs in Medicare

PR Newswire

WASHINGTON, May 22, 2018 /PRNewswire-USNewswire/ -- The Pharmaceutical Care Management Association (PCMA) issued the following statement today on a new Avalere study, Generic Drugs in Medicare Part D, Trends in Tier Structure and Placement, released by the Association for Accessible Medicines:

As the Avalere study points out, putting more expensive generics in non-preferred tiers helps keep premiums low.
According to the Government Accountability Office (GAO): "Copayments for generic drugs under Medicare Part D ranged from $0 to $13 in 2016, depending on the plan and whether the generic drug is included as a preferred or non-preferred generic on the plan sponsor's drug formulary."
GAO also found: "More than 300 of the 1,441 established generic drugs analyzed had at least one extraordinary price increase of 100 percent or more between first quarter 2010 and first quarter 2015."
Cost sharing for preferred generics is lower than it was 10 years ago, according to the Kaiser Family Foundation (KFF).
Cost sharing for preferred and non-preferred generics remains low. "Median cost sharing for preferred generics is $1 for PDPs and $3 for MA-PD plans in 2016, down from $5 in 2006. For drugs on the non-preferred generic tier—a tier that became common in 2012—median cost sharing is $7 for PDPs and $12 for MA-PD plans," according to KFF.
Nearly 90 percent of prescriptions filled in Part D are for generic medications.

PCMA is the national association representing America's pharmacy benefit managers (PBMs). PBMs administer prescription drug plans for more than 266 million Americans who have health insurance from a variety of sponsors including: commercial health plans, self-insured employer plans, union plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), state government employee plans, Medicaid plans, and others.

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