PCMA Statement on New Avalere Study Examining Generic Drugs in Medicare

(Washington, D.C.) — 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.