|Selected research from leading health care experts whose findings have a direct bearing on public policies effecting medical progress. Research is chosen based on its quality and relevance by the Medical Progress Today editorial staff.||
Effects Of Generic-Only Drug Coverage In A Medicare HMO
Are new drugs generally more effective than older, generic medications? Or can older drugs be relied upon as less expensive substitutes for newer, patented medications. This study, published online in Health Affairs, examined a California HMO whose drug coverage switched to a generic-only benefit. The study found that "the change was associated with reduced health plan pharmacy cost, increased out-of-pocket pharmacy costs for members, increased overall hospital admissions, changed-drug use patterns, and a negative impact on quality for certain conditions", namely congestive heart failure (CHF), coronary artery disease, diabetes, and antidepressant medication use.
The authors think the results "warrant further study", particularly since "pharmacy cost savings may be eroded by increased total medical costs for these members, especially in light of increased hospital admissions." The impetus to use cheaper, generic drugs as first-line medications is tempting given the financial constraints facing both private and public insurance programs; however, policymakers should remain aware that newer medications may be more cost-effective than older treatments, and work hard to ensure that short term cost pressures do not overwhelm other cost/quality considerations.
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