Even before the much-debated spike in generic drug prices occurred a few years ago, seniors who obtained these medicines through Medicare Part D plans were increasingly paying more than they had previously, according to a new analysis.
Why? Generics were being placed on insurance formularies that required seniors to pay more out-of-pocket costs. These formularies are lists of medicines for which insurance coverage is provided, but there are different tiers, or levels, and insurers were continually placing more generics on higher tiers that require greater out-of-pocket spending.
Specifically, the number of generics placed on the lowest tier, where patients pay less for their drugs, declined 53 percent between 2011 and 2015. This shift resulted in a 93 percent increase in total patient cost sharing for these drugs, or a total of $6.2 billion, according to the analysis by the Avalere health consulting firm. The analysis used volume-weighted prices, by the way.
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