A lot of attention has recently been given to the economic impact on pharmacy’s stocking expensive new hepatitis C medicines.
However, if the United States provides an example of what may be heading our way, the pharmacy sector in Australia may have to prepare for many other such scenarios in the near future.
According to a US Medicaid report, “the launch of several expensive hepatitis C drugs over the past few years has ushered the topic of high cost prescription drugs back into the public’s and policymakers’ attention”.
Among the most commonly prescribed outpatient prescription drugs in Medicaid, the top five drugs are used for pain relief (hydrocodone-acetaminophen and ibuprofen), management of chronic illness (lisinopril and omeprazole), and antibiotics (amoxicillin). However, these drugs are not necessarily among the most costly used by Medicaid as many are inexpensive at the per prescription level.
Nearly three quarters of the 50 most costly drugs fall into five drug groups, the report reveals, of which the most prevalent is antivirals, which includes drugs used to treat HIV as well as hepatitis C drugs.
Many of the most costly drugs have some form of regulatory and consequently market exclusivity, thus enabling the manufacturers to charge a premium price for the drug at the prescription level. Twenty two of the fifty most costly drugs are particularly expensive at the prescription level, including the most costly drug before rebates used by Medicaid over this period, Abilify (an atypical antipsychotic).
45 of the 50 most costly drugs fall into the high-cost category in part or primarily because they are frequently prescribed. Hydrocodone-acetaminophen and Suboxone, both opioids, a drug group which has garnered much public attention recently, fall into this category, as do several drugs used to treat ADHD.
The twelve costliest, in terms of total spend, are:
1 Abilify Antipsychotics/Antimanic Agent
2 Sovaldi Antiviral
3 Vyvanse ADHD/Anti-Narcolepsy/AntiObesity/Anorexiant
4 Harvoni Antiviral
5 Truvada Antivirals
6 Lantus Antidiabetic
7 Methylphenidate HCI ER ADHD/Anti-Narcolepsy/AntiObesity/Anorexiants
8 Atripla Antivirals
9 Advair Diskus Antiasthmatic and Bronchodilator Agent
10 Lantus SoloStar Antidiabetics
11 Seroquel Antipsychotics/Antimanic Agents
12 Latuda Antipsychotics/Antimanic Agents