Articles/Links: Expanded Use of Generic Drugs
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Generic Drug Utilization in State Medicaid Programs
Author: D. Levinson – July, 2006
Publication: Office of the Inspector General, U.S. Department of Health and Human Services
This report from the Office of the Inspector General assesses generic drug utilization rates in state Medicaid programs by calculating generic substitution rates (the percentage of all prescriptions for multisource drugs that were dispensed as generics) and the single source prescribing rate (percentage of prescriptions written for single-source drugs). The report recommends that CMS assist states in (1) targeting drug classes where the substitution rate is lower than average and (2) where possible, shifting utilization from single source to multisource drugs in a “clinically responsible manner.” -
Economic Consequences of Underuse of Generic Drugs: Evidence from Medicaid and Implications for Prescription Drug Benefit Plans
Authors: M. Fischer and J. Avorn – August, 2003
Publication: Health Services Research
The authors review Medicaid drug spending on a state-by-state basis and examine the system wide underuse of generic drugs, especially in several drug classes, and estimate large potential savings in government programs; the unrealized savings are concentrated in three classes of drugs. Optimal implementation of generic substitution varies widely among states, and the authors recommend more consistent generic substitution practices, research into physician prescribing habits, and investment in physician education. -
A Primer: Generic Drugs, Patents and the Pharmaceutical Market
Author: National Institute for Health Care Management Research and Education Foundation – June, 2002
Publication: NIHCM Foundation
This primer provides basic information on the state of generic drug usage and regulation in the U.S., including the Hatch-Waxman Act; the FDA orange book; the concept of bioequivalence as it functions in the generic market; the prescribing patterns of generics within Medicare and Medicaid; and an overview of states that require generic substitution by law. Short case studies illustrate the debate surrounding generics issues, and there are summaries of potential obstacles to increasing the use of generic drugs. -
The Importance of the Physician in the Generic Versus Trade-Name Prescription Decision
Author: J. Hellerstein – Spring, 1998
Publication: The Rand Journal of Economics
Using statistical modeling, the author found that physicians’ prescribing habits do not significantly correlate with state generic-substitution laws, a patient’s insurance plan or observable characteristics of individual patients. The author concludes that a physician’s prescribing preferences are a primary factor in whether a patient receives brand-name or generic drugs.READ MORE »



