دورية أكاديمية
Added Therapeutic Benefit of Top-Selling Brand-name Drugs in Medicare.
| العنوان: | Added Therapeutic Benefit of Top-Selling Brand-name Drugs in Medicare. |
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| المؤلفون: | Egilman AC; Division of Pharmacoepidemiology and Pharmacoeconomics, Program on Regulation, Therapeutics, and Law (PORTAL), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts., Rome BN; Division of Pharmacoepidemiology and Pharmacoeconomics, Program on Regulation, Therapeutics, and Law (PORTAL), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.; Harvard Medical School, Boston, Massachusetts., Kesselheim AS; Division of Pharmacoepidemiology and Pharmacoeconomics, Program on Regulation, Therapeutics, and Law (PORTAL), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.; Harvard Medical School, Boston, Massachusetts. |
| المصدر: | JAMA [JAMA] 2023 Apr 18; Vol. 329 (15), pp. 1283-1289. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Medical Association Country of Publication: United States NLM ID: 7501160 Publication Model: Print Cited Medium: Internet ISSN: 1538-3598 (Electronic) Linking ISSN: 00987484 NLM ISO Abbreviation: JAMA Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Chicago : American Medical Association, 1960- |
| مواضيع طبية MeSH: | Drug Costs*/legislation & jurisprudence , Medicare Part B*/economics , Medicare Part B*/legislation & jurisprudence , Medicare Part D*/economics , Medicare Part D*/legislation & jurisprudence , National Health Programs*/economics , National Health Programs*/legislation & jurisprudence , Prescription Drugs*/economics , Patents as Topic*, Cross-Sectional Studies ; Drugs, Generic ; Health Expenditures ; United States ; Canada ; France ; Germany |
| مستخلص: | Importance: The Inflation Reduction Act of 2022 authorizes Medicare to negotiate prices of top-selling drugs based on several factors, including therapeutic benefit compared with existing treatment options. Objective: To determine the added therapeutic benefit of the 50 top-selling brand-name drugs in Medicare in 2020, as assessed by health technology assessment (HTA) organizations in Canada, France, and Germany. Design, Setting, and Participants: In this cross-sectional study, publicly available therapeutic benefit ratings, US Food and Drug Administration documents, and the Medicare Part B and Part D prescription drug spending dashboards were used to determine the 50 top-selling single-source drugs used in Medicare in 2020 and to assess their added therapeutic benefit ratings through 2021. Main Outcomes and Measures: Ratings from HTA bodies in Canada, France, and Germany were categorized as high (moderate or greater) or low (minor or no) added benefit. Each drug was rated based on its most favorable rating across countries, indications, subpopulations, and dosage forms. We compared the use and prerebate and postrebate (ie, net) Medicare spending between drugs with high vs low added benefit. Results: Forty-nine drugs (98%) received an HTA rating by at least 1 country; 22 of 36 drugs (61%) received a low added benefit rating in Canada, 34 of 47 in France (72%), and 17 of 29 in Germany (59%). Across countries, 27 drugs (55%) had a low added therapeutic rating, accounting for $19.3 billion in annual estimated net spending, or 35% of Medicare net spending on the 50 top-selling single-source drugs and 11% of total Medicare net prescription drug spending in 2020. Compared with those with high added benefit, drugs with a low added therapeutic rating were used by more Medicare beneficiaries (median 387 149 vs 44 869) and had lower net spending per beneficiary (median $992 vs $32 287). Conclusions and Relevance: Many top-selling Medicare drugs received low added benefit ratings by the national HTA organizations of Canada, France, and Germany. When negotiating prices for these drugs, Medicare should ensure they are not priced higher than reasonable therapeutic alternatives. |
| التعليقات: | Comment in: J Comp Eff Res. 2023 Sep;12(9):e230120. (PMID: 37515489) Comment in: JAMA. 2023 Aug 15;330(7):665. (PMID: 37581677) |
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| المشرفين على المادة: | 0 (Drugs, Generic) 0 (Prescription Drugs) |
| تواريخ الأحداث: | Date Created: 20230418 Date Completed: 20230421 Latest Revision: 20240423 |
| رمز التحديث: | 20240423 |
| مُعرف محوري في PubMed: | PMC10114018 |
| DOI: | 10.1001/jama.2023.4034 |
| PMID: | 37071095 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1538-3598 |
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| DOI: | 10.1001/jama.2023.4034 |