Potential Savings Associated with Drug Substitution in Medicare Part D: The Translating Research into Action for Diabetes (TRIAD) Study

被引:15
作者
Duru, O. Kenrik [1 ]
Ettner, Susan L. [1 ,4 ]
Turk, Norman [1 ]
Mangione, Carol M. [1 ,4 ]
Brown, Arleen F. [1 ]
Fu, Jeffery [1 ]
Simien, Leslie [1 ]
Tseng, Chien-Wen [2 ,3 ]
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA
[2] Univ Hawaii, John A Burns Sch Med, Honolulu, HI 96822 USA
[3] Pacific Hlth Res & Educ Inst, Honolulu, HI USA
[4] Univ Calif Los Angeles, UCLA Fielding Sch Publ Hlth, Dept Hlth Policy & Management, Los Angeles, CA 90095 USA
关键词
pharmacoeconomics; Medicare; health care policy; THERAPEUTIC SUBSTITUTION; IMPACT; COST; IMPLEMENTATION;
D O I
10.1007/s11606-013-2546-6
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Drug substitution is a promising approach to reducing medication costs. To calculate the potential savings in a Medicare Part D plan from generic or therapeutic substitution for commonly prescribed drugs. Cross-sectional, simulation analysis. Low-income subsidy (LIS) beneficiaries (n = 145,056) and non low-income subsidy (non-LIS) beneficiaries (n = 1,040,030) enrolled in a large, national Part D health insurer in 2007 and eligible for a possible substitution. Using administrative data from 2007, we identified claims filled for brand-name drugs for which a direct generic substitute was available. We also identified the 50 highest cost drugs separately for LIS and non-LIS beneficiaries, and reached consensus on which drugs had possible therapeutic substitutes (27 for LIS, 30 for non-LIS). For each possible substitution, we used average daily costs of the original and substitute drugs to calculate the potential out-of-pocket savings, health plan savings, and when applicable, savings for the government/LIS subsidy. Overall, 39 % of LIS beneficiaries and 51 % of non-LIS beneficiaries were eligible for a generic and/or therapeutic substitution. Generic substitutions resulted in an average annual savings of $160 in the case of LIS beneficiaries and $127 in the case of non-LIS beneficiaries. Therapeutic substitutions resulted in an average annual savings of $452 in the case of LIS beneficiaries and $389 in the case of non-LIS beneficiaries. Our findings indicate that drug substitution, particularly therapeutic substitution, could result in significant cost savings. There is a need for additional studies evaluating the acceptability of therapeutic substitution interventions within Medicare Part D.
引用
收藏
页码:230 / 236
页数:7
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