FIRM- AND DRUG-SPECIFIC PATTERNS OF GENERIC DRUG PRICES EXPERIENCED BY UNITED STATES MEDICAID PROGRAMS- 1991-2008

Author(s)

Berry EA1, Kelton CM2, Yu Y2, Guo JJ3, Bian B1, Heaton PC11University of Cincinnati, Cincinnati, OH, USA, 2University of Cincinnati College of Business, Cincinnati, OH, USA, 3University of Cincinnati Medical Center, Cincinnati, OH, USA

OBJECTIVES:  After the patent expires for a branded pharmaceutical, generic drug companies generally sell bioequivalent versions of the drug, leading to lower prices. Considering more drugs over a longer period of time than previously in the literature, the objectives were to (1) describe the trends in branded and generic drug prices post-entry; and (2) estimate the effects of drug, firm, and market characteristics on branded and generic prices. METHODS:  The primary data source was the Medicaid State Drug Utilization Data maintained by the Centers for Medicare & Medicaid Services.  Quarterly utilization and expenditure data from 1991-2008 were extracted for 83 drugs that experienced initial generic entry between 1992 and 2004.  A relative price for a specific drug, firm, and quarter was constructed as Medicaid reimbursement per unit divided by average reimbursement per unit of the branded drug the year before entry.  Autoregressive fixed-effects and random-effects models were estimated to explain relative drug price. RESULTS:  For the 83 drugs, prices for 229 firms were followed from the first quarter of generic entry until 2008. Twelve quarters after generic entry, 17% of drugs had average relative generic price less than 50% of the original branded price. The number of firms had a statistically significant (p<0.01) negative effect on price.  For each additional firm manufacturing the generic drug, average price was estimated to fall by 8 percentage points. Higher demand had a statistically significant (p<0.01) positive effect.  No statistically significant price premium for either early entry or firm size was found.  Injectable drugs had prices that fell less (p<0.01) than other drugs.  CONCLUSIONS: Results are consistent with earlier studies showing that branded-drug prices rise and generic drug prices fall as more generic firms enter.  However, this fall is not as strong for injectable drugs or for drugs with high demand.

Conference/Value in Health Info

2012-06, ISPOR 2012, Washington, D.C., USA

Value in Health, Vol. 15, No. 4 (June 2012)

Code

UT3

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies

Disease

Multiple Diseases

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