More out-of-pocket costs for US patients with rising prescription drug prices

Generics/Research | Posted 31/05/2021 post-comment0 Post your comment

Increasing prices of brand-name drugs in the US, leaves patients with increasing costs at the pharmacy, says a study published in JAMA Network Open [1]. 

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In the US, list prices set by manufacturers for brand-name prescription drugs have
been increasing at a higher rate than inflation. This is largely due to the lack of drug price regulation in the US. Most insured patients are required to pay at least some out-of-pocket costs for their medication. With higher patient spending being associated with lower treatment adherence and reduced health outcomes, this is a concern.

Now, a team of researchers led by Dr Benjamin Rome, an instructor of medicine at Harvard Medical School and a researcher at Brigham and Women’s Hospital in Boston, reported that between 2015 to 2017 the list price of 79 brand-name drugs increased by over 16 per cent while average patient out-of-pocket costs went up by over three per cent.

Approximately half of insured patients are insulated from drug price rises as they have fixed copayments. However, the other half, whose insurance requires coinsurance or deductibles are left with increasing out-of-pocket costs. Dr Rome and his colleagues suggest that the removal of rebates, paid by manufacturers to insurers to off-set price increases, could prevent this latter group of patients from paying more for their medication. Alternatively, insurance companies could pass these rebates on to patients.

Patients could save by buying generic or biosimilar alternatives to brand-name products that are available for the same indications. In many cases, these will be cheaper to buy outright, than the out-of-pocket cost of the brand-name drug offered under a patient’s insurance policy. However, pharmacists are often prevented from offering cheaper alternatives due to agreements with insurance companies. This should now be made possible in some states with the advent of a series of bills that will give pharmacists the ability to recommend cheaper drug options [3].

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To further enhance the objectives of GaBI in sharing information and knowledge that ensure policies supportive of safe biosimilars use, we are pleased to announce that we will be launching a new section on GaBI Online and GaBI Journal, the ‘Latin American Forum’ (in Spanish) featuring the latest news and updates on research and developments in generic and biosimilar medicines in Latin America.

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Para fomentar los objetivos de GaBI sobre la difusión de información y conocimiento sobre las políticas de apoyo que garantizan el uso seguro de medicamentos biosimilares, nos complace anunciar el lanzamiento de una nueva sección en GaBI Online y GaBI Journal, el ‘Latin American Forum’ (en español), que presentará las últimas noticias y actualizaciones en investigación y desarrollo sobre medicamentos genéricos y biosimilares en Latinoamérica.

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1. Rome BN, Feldman WB, Desau RJ, et al. Correlation between changes in brand-name drug prices and patient out-of-pocket costs. Original Investigation Health Policy. JAMA Netw Open. 2021;4(5):e218816.
2. GaBI Online - Generics and Biosimilars Initiative. Bills increase access to affordable []. Mol, Belgium: Pro Pharma Communications International; [cited 2021 May 28]. Available from:

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