The cost of brand-name drugs is 2-3 times greater in the United States than in other countries. However, some of the top-selling brand name drugs may not offer much extra therapeutic benefit. Using public Medicare data, researchers at Brigham and Women’s Hospital, a founding member of Mass General Brigham, identified the 50 most popular brand-name drugs in 2020. They then assessed their therapeutic benefits in comparison to existing standards of care, using ratings from the national health technology assessment (HTA) organizations of Canada, France, and Germany. Despite accounting for 11% of net Medicare prescription drug spending, 27 of the 50 drugs received low added therapeutic benefit ratings from these agencies. The results of the study have been published in JAMA.
"Compared to many other developed nations, the United States lacks a national system for evaluating the clinical advantages of drugs when compared to existing treatment options, and subsequently, for negotiating prices based on the additional therapeutic benefits they provide to patients," explained Alexander C. Egilman, BA, the first author and member of the Brigham Division of Pharmacoepidemiology and Pharmacoeconomics. "As a result, our primary objective was to examine the added therapeutic benefits of costly Medicare drugs, using assessments from foreign HTA organizations."
Most of the top-selling drugs were used to treat endocrine conditions including diabetes, cancer and respiratory diseases. Data from HTA organizations were available for 49 of the drugs.
In 2022, the Inflation Reduction Act will enable Medicare to negotiate prices for the most popular drugs for the first time. The Centers for Medicare and Medicaid Services have provided initial guidelines that suggest negotiations will be strongly influenced by a drug's comparative effectiveness when compared to other therapeutic options. The recent study discovered that seven out of the ten drugs that are likely to be chosen for negotiation in September have limited added therapeutic benefits.
According to corresponding author Aaron S. Kesselheim, MD, JD, MPH, of the Brigham Division of Pharmacoepidemiology and Pharmacoeconomics, "The new pricing negotiation model introduced by the Inflation Reduction Act presents an excellent opportunity for Medicare to cease overpaying for popular drugs that offer little clinical benefits when compared to cheaper treatments. Our study shows that Medicare has various criteria for negotiation, which will ensure that the prices of top-selling drugs are, at the very least, not higher than those of alternative therapeutic options." (PB/Newswise)