The survey of 700 pharmacists was carried out by the National Community Pharmacists Association (NCPA), which represents America’s community pharmacists, and published on 7 April 2015.

The results showed that 99.9% of pharmacists surveyed had experienced a large upswing in the acquisition price of a generic drug in the last six months, with 27% experiencing more than 100 such instances. This fact was backed up by the experience of 93.4% of pharmacists, who described the situation of generics price spikes as having ‘gotten worse’ since 2013.

Where pharmacists had experienced a dramatic upswing in the acquisition price of a generic drug, 62.3% had also experienced that it took three months or more for the pharmacy benefit managers (PBMs) or other third-party payers to correspondingly update pharmacy reimbursement rates. A total of 24.7% of pharmacists also experienced that it took one to two months before pharmacy reimbursement rates were updated.

When PBMs do not update generics reimbursement rates to reflect price inflation, community pharmacies have to absorb financial losses on those prescriptions. Despite this fact, most pharmacists (92.8%) thought that the situation had ‘gotten worse’ since 2013.

Most pharmacists (82.8%) also experienced that when they appealed to PBMs to correct the underpayments for rising generics costs the appeal was rejected (56.9%) or they received no response (25.9%).

NCPA concludes that patient access to generics and community pharmacies are both increasingly at risk due to inadequate reimbursement rates that fail to cover the cost of filling prescriptions.

In response to claims of soaring generics prices the US Department of Health and Human Services (HHS) has agreed to investigate recent price increases in generics and how such increases have affected the Medicaid* programme in the US [1]. The Centers for Medicare & Medicaid Services (CMS), in response to the NCPA’s concerns, issued a final rule in May 2014 to require price updates in Medicare Part D every seven days starting in 2016.

*Medicaid is the largest source of funding for medical and health related services for people with low income in the US.

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Investigation into huge price increases for generics in US

Reference
1.   GaBI Online - Generics and Biosimilars Initiative. Soaring generics prices come under increased scrutiny [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2015 May 8]. Available from: www.gabionline.net/Generics/General/Soaring-generics-prices-come-under-increased-scrutiny 

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