OBJECTIVES:  After amendments were made to the law in the favor of generic drug makers, this market saw an influx of new players, which brought generic prices further down. Currently, on average, the cost of a generic drug is METHODS:  The difference with generic prices has been obtained by the Medicaid file using National Average Drug Acquisition Cost (NADAC) Weekly reference file. The NADAC for prescription and over-the-counter covered outpatient drugs is reported at the 11-digit National Drug Code level.

RESULTS:  Most extraordinary price increases were between 100 and 200 percent. 48 were 500 % or higher. 15 were 1,000 % or higher. Clomipramine HCL/50mg/capsule/oral, 2,000 % in 1 year, $0.34 per capsule in the first quarter of 2013 to $8.43 per capsule in the first quarter of 2014. 183 out of the 351 extraordinary price increases were less than 200 % Hydrocortisone/20mg/tablet/oral. 160 % in 1 year, $0.16 per tablet in the first quarter of 2012 to $0.41 per tablet in the first quarter of 2013. CONCLUSIONS: Based on the analyses conducted to date, a vibrant generic market can exert downward pressure on overall drug prices. Generic drugs account for majority of prescriptions filled in US and represent lower costs to healthcare system.Factors such as drug shortages, the ability to obtain new market exclusivities, the distribution system, small market size, and consolidation in the generic drug industry present potential barriers to ongoing competition in the generic drug market, and will be subject of continued study.