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This study compares Medicare and patient spending for dual over-the-counter and prescription drugs with their over-the-counter cash prices. [ABSTRACT FROM AUTHOR]

This article explains the complex and opaque pricing structure of drugs in the United States; how it exposes patients to higher out-of-pocket payments, including for drugs such as insulin; and policy changes that may offer relief. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has revealed the vulnerability of the US generic drug supply chain to foreign production. Many policies have been proposed to mitigate this vulnerability. In this article, we argue that nonprofit drug manufacturers have the potential to make important contributions. [ABSTRACT FROM AUTHOR]

The 60 drugs and the programs covering them represented 401 unique drug-program pairs. As presented in Figure 1, the likelihood of a drug being covered by any patient assistance programs for off-label uses was positively associated with the total number of different programs covering the drug. Among the 167 drugs covered by one or two patient assistance programs, only four drugs (2%) were covered for off-label uses; among the 44 drugs covered by five and more programs, 36 drugs (82%) were covered for off-label uses. [Extracted from the article]

This study aimed to characterize products using pharmacy-pharmacy benefit manager (PBM) discounts and to estimate the association among such discounts, prescription utilization, and out-of-pocket costs. This is a retrospective cohort study using IQVIA's Formulary Impact Analyzer, which contains anonymized, individual-level pharmacy claims representing US retail pharmacy transactions. We focused on 20 products with the greatest number of transactions using a pharmacy-PBM discount. Our unit of analysis was a treatment episode, defined as the length of time from an incident fill to no continuous use for 60 consecutive days after allowing for indefinite stockpiling. Outcome measures included products with greatest pharmacy-PBM discount use, characteristics of treatment episodes, and out-of-pocket costs with and without pharmacy-PBM discount. Across all products, 3.82% of transactions and 7.69% of treatment episodes were accompanied by a pharmacy-PBM discount. Commonly discounted products included generic treatments for chronic disease (lisinopril, levothyroxine, metformin) and neuropsychiatric conditions (alprazolam, amphetamine, buprenorphine, hydrocodone). The median postdiscount out-of-pocket cost was >2.5-fold higher during treatment episodes with a discount than those without ($15.15, interquartile range [IQR] $8.53-32.00, vs $5.88, IQR $1.40-15.00). Median treatment episode duration was 249 days (IQR 132-418) with discount use compared with 236 days (IQR 121-396) without discount use, although treatment episodes that began with a discount had fewer transactions per treatment episode and were shorter (median 212 days, IQR 114-360) than those that did not (313 days, IQR 178-500). Pharmacy-PBM discounts may foster market competition and improve access for under- and uninsured individuals; however, these programs may not generate savings for many insured individuals. • Approximately half of drug discounts originate from pharmacy-pharmacy benefit manager (PBM) programs rather than drug manufacturers, yet little is known regarding the use and impact of these programs. • In this retrospective cohort of individuals using anonymized, longitudinal, patient-level pharmacy claims, pharmacy-PBM discounts were used for 3.82% of transactions. Across all treatment episodes, the median postdiscount out-of-pocket cost was >2.5-fold higher during treatment episodes with a discount than those without. Treatment episodes that began with a discount had fewer transactions per treatment episode and were shorter than those that did not. • Pharmacy-PBM discounts may foster market competition and improve access for under- and uninsured individuals; nevertheless, these programs may not generate savings for many insured individuals. [ABSTRACT FROM AUTHOR]