In a study titled Racial differences in antilipemic use and lipid control in high-risk older adults: Post–Medicare Part D, researchers observed increased use of cholesterol controlling medications in both blacks and whites after Medicare Part D, but no significant change in earlier racial disparities. Before 2006, 36 percent of black participants and 29 percent of white participants were taking cholesterol medications. After Medicare Part D, the rates rose to 48 and 65 percent, respectively.
CVS Caremark’s recent initiative to limit inappropriate prescribing of high-risk drugs (i.e., hydrocodone, oxycodone, alprazolam, methadone, and carisoprodol) demonstrates a role that pharmacies can play in patient safety. Using submitted prescriptions for the aforementioned drugs, CVS Caremark identified and contacted prescribers they believed to be outliers relative to their geographic region and medical specialty. If outliers did not respond or did not provide legitimate reasons for their prescribing habits, CVS Caremark stopped filling their prescriptions.
When studying the possibility of an “offsetting effect” that prescription drug use would have on spending for medical services, the Congressional Budget Office (CBO) previously did not find sufficient evidence to indicate that such a relationship existed. Thus, an “offsetting effect” was not taken into consideration when estimating spending in the Medicare Modernization Act of 2003 and the Affordable Care Act. However, after reviewing recent studies, the CBO now estimates that a 1 percent increase in the number of prescriptions filled by beneficiaries would cause Medicare’s spending on medical services to fall by approximately 0.2 percent. This relationship will be incorporated in future budgetary estimations.
Though biosimilar drugs are not yet sold, marketed, or FDA-approved, they are already the topic of regulation in state legislatures. A bill that would allow pharmacists to substitute cheaper, FDA-approved biosimilar drugs for their brand name counterparts passed by wide margins in the California Assembly and Senate, and now needs Governor Jerry Brown’s signature. According to the bill, prescribers can indicate “do not subscribe” to prevent pharmacists from dispensing substitutes. Otherwise, pharmacists would be required to notify prescribers of any biosimilar or biological drug selections within five business days.
Other states have already passed or considered similar legislation regulating access to biosimilar drugs. For a map from the Generic Pharmaceutical Association, click here.