Columbus, OHIn a controversial report, researchers suggest that $73 billion might have been spent unnecessarily over a 3-year period because of prescriber or patient insistence on brand-name medications.

The article published online by JAMA Internal Medicine used data on 107,132 individuals in the Medical Expenditure Panel Survey from 2010 and 2012 to come to that conclusion.

The study team from Ohio State University and the University of Michigan focused on reported prescription medicine use to estimate potential savings through therapeutic substitution, examining both overall and out-of-pocket expenditures.

“We wanted to see how much patients and society as a whole could save through the use of therapeutic substitution, in terms of both overall and out-of-pocket expenses on brand drugs, when a generic drug in the same class with the same indication was available,” lead author Michael Johansen, MD, MS, said in an Ohio State press release.

Many medical organizations oppose the promotion of therapeutic substitution, perceiving it as an attack on prescribers’ autonomy.

The recent study included drug classes that contained a brand-name drug as well as generic and/or widely accessible OTC alternatives.

Results indicate that 62.1% of patients reported using prescribed medicine between 2010 and 2012, with 31.5% prescribed one of the drug categories being studied. Overall, a branded drug from an included class was used by 16.6% respondents, while 24% used a generic and 9.1% used both.

According to study authors, extra expenditures because of brand drug overuse made up 9.6% of total prescription medication costs. As for out-of-pocket expenditures between 2010 and 2012, which totaled $175 billion, the report suggests that brand drug overuse accounted for 14.1% of that.

Statins, atypical antipsychotics, proton pump inhibitors, selective serotonin reuptake inhibitors, and angiotensin receptor blockers were the drug classes topping the list of the greatest extra expenditure for brand name products, according to the study.

“There was a large amount of excess expenditure on branded drugs between 2010 and 2012 in classes that could have incorporated therapeutic substitution,” study authors write. “Although therapeutic substitution is controversial, it offers a potential mechanism to decrease drug costs if it can be implemented in a way that does not negatively affect quality of care.”

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