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OSTEOPOROSIS DRUGS MARKETED IN THE UNITED STATES: GENERIC COMPETITION, PRICING STRUCTURE, AND DISPERSION AMONG PAYERS

Published online by Cambridge University Press:  09 January 2017

Bander Balkhi ,
Enrique Seoane-Vazquez  and
Rosa Rodriguez-Monguio
Bander Balkhi
Affiliation:
Massachusetts College of Pharmacy and Health Sciences, Pharmaceutical Sciences
Enrique Seoane-Vazquez
Affiliation:
Massachusetts College of Pharmacy and Health Sciences, Pharmaceutical Sciences Brigham and Women's Hospital, Division of General Medicine and Primary Care
Rosa Rodriguez-Monguio
Affiliation:
University of Massachusetts, Amherst - Health Policy and Managementrmonguio@schoolph.umass.edu
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Abstract

Background: Despite the cost of pharmaceuticals, studies assessing prices of osteoporosis drugs are lacking. This study examined trends in prices of osteoporosis drugs in the United States in the period 1988–2014, assessed pricing structure of osteoporosis drugs, and evaluated price trends before and after generic drugs market entry.

Methods: Data were derived from the U.S. Food and Drug Administration, the RedBook, the Centers for Medicare & Medicaid Services, and the Federal Supply Schedule (FSS). Descriptive statistics and segmented linear regression analyses were performed.

Results: In the period 1988–2014, osteoporosis drug prices increased faster than the inflation. The average wholesale price (AWP) of generic products at market entry represented 90 percent of the AWP for the corresponding brand. Prices of brand products continued to increase after generic entry. Drug prices showed a significant variation when compared with the brand AWP. The brand wholesale acquisition cost (WAC) was typically set at 83.3 percent of the AWP. Community pharmacies acquired osteoporosis brand drugs at a median of 80.5 percent of the brand AWP. Significant reductions in brand AWP were observed for Medicare Part B (78.5 percent of the brand AWP), generic National Average Drug Acquisition Cost (33.7 percent), and FSS (22.5 percent).

Conclusions: There are significant differences in the manufacturer prices, pharmacy acquisition costs and reimbursement rates of osteoporosis drugs. Pharmaceutical companies listed prices are higher than the pharmacy actual estimated acquisitions costs, and the prices used for reimbursement to providers. Generic drugs entry significantly drives down prices; still, prices of branded drugs facing generic competition continued to increase after generic market entry.

Keywords

Osteoporosis drugsDrug pricesGeneric drugsMarket competition
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 32 , Issue 6 , 2016 , pp. 385 - 392
Copyright
Copyright © Cambridge University Press 2017 

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References

REFERENCES

1. Reginster, J, Burlet, N. Osteoporosis: A still increasing prevalence. Bone. 2006;38:4–9.CrossRefGoogle ScholarPubMed
2. Burge, R, Dawson-Hughes, B, Solomon, DH, et al. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res. 2007;22:465–475.CrossRefGoogle ScholarPubMed
3. Vincent, GK, Velkoff, VA. The next four decades: The older population in the United States: 2010 to 2050. Washington, DC: US Department of Commerce, Economics and Statistics Administration, US Census Bureau; 2010.Google Scholar
4. Silverman, SL. Quality-of-life issues in osteoporosis. Curr Rheumatol Rep. 2005;7:39–45.CrossRefGoogle ScholarPubMed
5. Robitaille, J, Yoon, PW, Moore, CA, et al. Prevalence, family history, and prevention of reported osteoporosis in US women. Am J Prev Med. 2008;35:47–54.CrossRefGoogle Scholar
6 Viswanathan, HN, Curtis, JR, Yu, J, White, J, et al. Direct healthcare costs of osteoporosis-related fractures in managed care patients receiving pharmacological osteoporosis therapy. Appl Health Econ Health Policy. 2012;10:163–173.CrossRefGoogle ScholarPubMed
7. Transparency Market Research (TMR), 2014. Osteoporosis drugs market – Global industry analysis, pipeline analysis, size, share, growth, trends & forecast, 2014–2020. Available at: http://www.transparencymarketresearch.com/osteoporosis-drug-market.html (accessed August 12, 2016).Google Scholar
8. IMS Institute for Healthcare Informatics. Declining medicine use and costs: For better or worse?. A review of the use of medicines in the United States in 2012. Available at: http://www.imshealth.com/files/web/IMSH%20Institute/Reports/Declining%20Medicine%20Use%20and%20Costs%20For%20Better%20or%20Worse/2012_U.S.Medicines_Report.pdf (accessed August 12, 2016).Google Scholar
9. National Osteoporosis Foundation. Clinician's guide to the prevention and treatment of osteoporosis. NOF, 2014. Available at: frphttp://nof.org/files/nof/public/content/file/2791/upload/919.pdf (accessed July 20, 2014).Google Scholar
10. Centers for Medicare and Medicaid Services. National Health Expenditures Data. Available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/index.html (accessed August 13, 2016).Google Scholar
11. Warriner, AH, Saag, KG. Osteoporosis diagnosis and medical treatment. Orthop Clin North Am. 2013;44:125–135.CrossRefGoogle ScholarPubMed
15. Parthan, A, Kruse, M, Yurgin, N, et al. Cost effectiveness of denosumab versus oral bisphosphonates for postmenopausal osteoporosis in the US. Appl Health Econ Health Policy. 2013;11:85–497.CrossRefGoogle ScholarPubMed
13. Centers for Medicare & Medicaid Services, Office of the Actuary, National health statistics group; 2012. National health expenditure projections 2012-2022. Available at: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/proj2012.pdf (accessed June 22, 2014).Google Scholar
14. Gencarelli, DM. One pill, many prices: Variation in prescription drug prices in selected government programs. Issue Brief George Wash Univ Natl Health Policy Forum. 2005;807:1–20.Google Scholar
15. Curtiss, FR, Lettrich, P, Fairman, KA. What is the price benchmark to replace average wholesale price (AWP)? J Manag Care Pharm. 2010;16:492–501.Google ScholarPubMed
16. 42 CFR 447.332 – Upper limits for multiple source drugs. Available at: https://www.gpo.gov/fdsys/granule/CFR-1999-title42-vol3/CFR-1999-title42-vol3-sec447-332 (accessed December 15, 2016).Google Scholar
17. Centers for Medicare & Medicaid Services. Pharmacy drug pricing. Available at: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Prescription-Drugs/Pharmacy-Pricing.html (accessed April 21, 2015).Google Scholar
18. Centers for Medicare & Medicaid Services. Federal upper limits. Available at: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Prescription-Drugs/Federal-Upper-Limits.html (accessed April 21, 2015).Google Scholar
19. Affairs, Veteran. Office of Acquisition and Logistics (OAL). Schedule 65 I B drugs, pharmaceuticals, & hematology related products. Available at: http://www.va.gov/oal/business/fss/pharmaceuticals.asp (accessed April 21, 2015).Google Scholar
20. World Health Organization. Guidelines for ATC classification and DDD assignment. WHO Collaborating Centre for Drug Statistics Methodology; 2013. Available at: http://www.whocc.no/atc/structure_and_principles (accessed July 11, 2014).Google Scholar
21. Red Book Online [database online]. Greenwood village, CO: Truven Health Analytics, Inc. (accessed January 31, 2015).Google Scholar
22. U.S. Department of Labor: Bureau of Labor Statistics. Consumer price index – all urban consumers. Available at: http://www.bls.gov/ro3/fax_9130.htm (accessed July 21, 2014).Google Scholar
23. Aitken, M, Berndt, ER, Cutler, DM. Prescription drug spending trends in the United States: Looking beyond the turning point. Health Aff. 2009;28:151–160.Google ScholarPubMed
24. Schumock, GT, Li, EC, Suda, KJ, Wiest, MD, et al. National trends in prescription drug expenditures and projections for 2015. Am J Health Syst Pharm. 2015;72:717–736.CrossRefGoogle Scholar
25. Balaban, DY, Dhalla, IA, Law, MR, Bell, CM. Private expenditures on brand name prescription drugs after generic entry. Appl Health Econ Health Policy. 2013;11:523–529.CrossRefGoogle ScholarPubMed
26. Saha, A, Grabowski, H, Birnbaum, H, et al. Generic competition in the US pharmaceutical industry. Int J Econ Bus. 2006;13:15–38.CrossRefGoogle Scholar
27. Regan, TL. Generic entry, price competition, and market segmentation in the prescription drug market. Int J Ind Organ. 2008;26:930–948.CrossRefGoogle Scholar
28. Kong, Y. Competition between brand-name and generics–Analysis on pricing of brand-name pharmaceutical. Health Econ. 2009;18:591–606.CrossRefGoogle ScholarPubMed
29. Gencarelli, DM. Average wholesale price for prescription drugs: Is there a more appropriate pricing mechanism? NHPF Issue Brief. 2002:1–19.Google Scholar
30. Scherer, FM. The pharmaceutical industry-prices and progress. N Engl J Med. 2004;351:927–932.CrossRefGoogle ScholarPubMed
31. Congressional Budget Office. The Congress of the United States. Prices for brand-name drugs under selected federal programs. Washington, DC: Congressional Budget Office; June 2005.Google Scholar
32. Office of Inspector General. Medicaid drug price comparisons: Average manufacturer price to published prices. Department of Health and Human Services. Washington, DC: Office of Inspector General; June 2005.Google Scholar
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