Measuring Generic Efficiency in Part D
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- Edmund Maxwell
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1 Measuring in Part D
2 Rates among Medicare Part D Generic efficiency rate is a measurement of the total number of prescrip=ons filled as a generic for products with a direct generic subs=tute within a therapeu=c area of interest Regardless of subsidy status or therapeu=c area, pa=ents almost always fill a generic molecule when it is available (greater than 94% across all therapeu=c areas of interest) There is lihle difference in generic efficiency between Low Income Subsidy and Non- Low Income Subsidy Part D pa=ents Medicare Part D Rate by Therapeu;c Area: LIS vs. Non- LIS Non- LIS LIS Therapeu;c Area An=- Depressant An=psycho=cs Dyslipidemia Epilepsy Hypertension 99.4% 99.1% 98.8% 98.0% 99.9% 99.9% 94.5% 94.6% 96.3% 96.5% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Rate 2
3 s among Medicare Part D Generic fill rate is a measurement of the total number of prescrip=ons filled as a generic for all products within a given therapeu=c area of interest While overall generic fill rate varied by therapeu=c area, there were only slight varia=ons in rate between Low Income Subsidy and Non- Low Income Subsidy pa=ents Medicare Part D by Therapeu;c Area: LIS vs. Non- LIS Non- LIS LIS Therapeu;c Area An=- Depressant An=psycho=cs Dyslipidemia Epilepsy Hypertension 36.1% 32.7% 82.6% 81.2% 73.5% 76.8% 95.5% 93.6% 88.6% 89.9% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 3
4 by Therapeu;c Area: An;- depressant AMITRIP HCL/CHLORDIAZEPOXIDE 49.6% 100.0% 100.0% 100.0% 12,319 AMITRIPTYLINE HCL 59.6% 100.0% 100.0% 100.0% 1,151,152 AMOXAPINE 52.2% 100.0% 100.0% 100.0% 3,979 CITALOPRAM HYDROBROMIDE 54.9% 99.9% 99.9% 99.9% 2,345,803 CLOMIPRAMINE HCL 71.3% 99.5% 99.4% 99.7% 25,034 DESIPRAMINE HCL 49.6% 98.9% 99.1% 98.7% 23,940 DOXEPIN HCL 60.1% 100.0% 100.0% 100.0% 212,815 FLUOXETINE HCL 58.9% 99.6% 99.5% 99.6% 1,317,803 FLUVOXAMINE MALEATE 75.4% 94.9% 95.1% 94.3% 44,929 IMIPRAMINE HCL 52.4% 99.9% 99.9% 99.9% 108,111 IMIPRAMINE PAMOATE 68.3% 96.3% 96.4% 96.1% 2,327 MAPROTILINE HCL 46.4% 100.0% 100.0% 100.0% 2,966 MIRTAZAPINE 60.2% 99.8% 99.8% 99.8% 694,179 NORTRIPTYLINE HCL 55.3% 99.9% 99.9% 99.9% 260,311 PAROXETINE HCL 57.4% 99.5% 99.5% 99.5% 1,148,908 PERPHENAZINE/AMITRIPTYLINE HCL 56.0% 100.0% 100.0% 100.0% 31,990 PROTRIPTYLINE HCL 54.9% 95.8% 96.5% 95.0% 2,818 SERTRALINE HCL 56.1% 99.6% 99.6% 99.6% 2,145,823 VENLAFAXINE HCL 55.9% 94.3% 92.8% 96.1% 886,944 USC Class Total 57.1% 99.2% 99.1% 99.4% 10,422,149 USC Class Total 57.4% 81.8% 81.2% 82.6% 12,641,597 USC Class = Anti- Depressants in Combination, Antidepressant- Tricyclic/Tetracyclic, SSRI (SEL. Serotonin Reuptake Inhibitor), SNRI (Serotonin/Norepi Reuptake Inhibit) 4
5 by Therapeu;c Area: An;psycho;c CLOZAPINE 91.7% 91.0% 90.6% 95.1% 118,469 HALOPERIDOL 83.0% 100.0% 100.0% 100.0% 166,801 HALOPERIDOL DECANOATE 92.6% 90.6% 90.6% 90.7% 27,423 HALOPERIDOL LACTATE 79.9% 99.3% 99.3% 99.7% 5,839 LOXAPINE SUCCINATE 83.6% 99.9% 99.9% 100.0% 15,389 RISPERIDONE 80.0% 99.3% 99.2% 99.6% 658,947 THIOTHIXENE 79.1% 97.3% 97.0% 98.1% 28,936 USC Class Total 82.2% 98.1% 98.0% 98.8% 1,021,804 USC Class Total 83.5% 33.3% 32.7% 36.1% 3,147,450 USC Class = Antipsychotics, Other 5
6 by Therapeu;c Area: Dyslipidemia LOVASTATIN 51.3% 99.9% 99.9% 99.9% 2,263,713 PRAVASTATIN SODIUM 47.9% 99.9% 99.9% 99.9% 3,104,877 SIMVASTATIN 50.7% 99.9% 99.9% 100.0% 12,398,875 USC Class Total 50.3% 99.9% 99.9% 99.9% 17,767,464 USC Class Total 49.0% 75.1% 76.8% 73.5% 23,959,755 USC Class = HMG- COA Reductase Inhibitors 6
7 by Therapeu;c Area: Epilepsy CARBAMAZEPINE 72.5% 72.7% 74.3% 68.5% 378,089 DIVALPROEX SODIUM 81.1% 95.6% 95.4% 96.5% 636,857 ETHOSUXIMIDE 81.3% 91.5% 93.8% 81.5% 3,231 FOSPHENYTOIN SODIUM 100.0% 100.0% 100.0% 0.0% 24 GABAPENTIN 61.2% 99.7% 99.7% 99.8% 3,315,370 LAMOTRIGINE 74.7% 93.7% 93.2% 95.0% 526,269 LEVETIRACETAM 68.8% 91.8% 90.9% 93.9% 438,192 OXCARBAZEPINE 76.7% 95.5% 95.2% 96.5% 155,443 PHENYTOIN 81.2% 32.4% 35.7% 18.3% 43,249 PHENYTOIN SODIUM 62.5% 100.0% 100.0% 100.0% 8 PHENYTOIN SODIUM EXTENDED 69.3% 79.1% 80.7% 75.5% 451,666 PRIMIDONE 52.7% 99.3% 99.0% 99.6% 199,867 TOPIRAMATE 74.9% 96.3% 95.9% 97.7% 430,494 VALPROATE SODIUM 90.5% 97.8% 97.8% 98.4% 21,475 VALPROIC ACID 67.7% 95.9% 94.9% 98.1% 25,170 ZONISAMIDE 71.9% 95.6% 94.8% 97.7% 57,488 USC Class Total 67.2% 94.6% 94.6% 94.5% 6,682,892 USC Class Total 66.4% 94.3% 93.6% 95.5% 7,111,892 USC Class = Seizure Disorders 7
8 by Therapeu;c Area: Hypertension AMLODIPINE BESYLATE 52.6% 99.7% 99.6% 99.7% 7,941,121 AMLODIPINE BESYLATE/BENAZEPRIL 42.9% 96.0% 94.4% 97.2% 889,232 BENAZEPRIL HCL 52.9% 99.8% 99.8% 99.7% 1,095,757 BENAZEPRIL/HYDROCHLOROTHIAZIDE 46.3% 99.8% 99.9% 99.7% 219,932 CAPTOPRIL 59.3% 100.0% 100.0% 100.0% 177,847 CAPTOPRIL/HYDROCHLOROTHIAZIDE 53.1% 100.0% 100.0% 100.0% 15,929 DILTIAZEM HCL 47.1% 75.9% 78.3% 73.7% 2,310,648 DOXAZOSIN MESYLATE 48.6% 99.8% 99.8% 99.8% 952,982 ENALAPRIL MALEATE 58.1% 99.8% 99.8% 99.7% 1,484,275 ENALAPRIL/HYDROCHLOROTHIAZIDE 52.6% 99.6% 99.7% 99.5% 109,142 EPLERENONE 33.6% 97.6% 96.7% 98.0% 28,755 FELODIPINE 38.7% 100.0% 100.0% 100.0% 320,088 FOSINOPRIL SODIUM 50.1% 100.0% 100.0% 100.0% 232,005 FOSINOPRIL/HYDROCHLOROTHIAZIDE 41.8% 100.0% 100.0% 100.0% 14,375 LISINOPRIL 51.9% 99.9% 99.9% 99.9% 9,593,282 LISINOPRIL/HYDROCHLOROTHIAZIDE 49.4% 99.9% 99.9% 99.9% 2,256,660 LOSARTAN POTASSIUM 46.8% 99.4% 99.3% 99.4% 2,398,740 MOEXIPRIL HCL 41.0% 98.7% 99.0% 98.5% 34,462 MOEXIPRIL/HYDROCHLOROTHIAZIDE 46.1% 98.7% 98.0% 99.2% 27,888 NICARDIPINE HCL 44.7% 99.8% 99.9% 99.8% 6,007 NIFEDIPINE 56.8% 48.4% 48.3% 48.4% 1,136,228 NIMODIPINE 78.3% 100.0% 100.0% 100.0% 281 PERINDOPRIL ERBUMINE 32.1% 90.0% 89.5% 90.3% 8,293 PRAZOSIN HCL 62.6% 99.8% 99.8% 99.7% 64,634 QUINAPRIL HCL 45.8% 99.4% 99.3% 99.5% 625,556 QUINAPRIL/HYDROCHLOROTHIAZIDE 35.6% 99.2% 99.1% 99.3% 53,805 RAMIPRIL 42.0% 99.3% 99.0% 99.4% 942,853 TERAZOSIN HCL 45.6% 100.0% 100.0% 100.0% 743,756 TRANDOLAPRIL 41.1% 98.7% 98.7% 98.7% 61,645 TRANDOLAPRIL/VERAPAMIL HCL 40.2% 77.5% 75.9% 78.5% 11,873 VERAPAMIL HCL 48.3% 99.5% 99.6% 99.5% 992,541 USC Class Total 50.5% 96.4% 96.5% 96.3% 34,750,590 USC Class Total 50.2% 89.2% 89.8% 88.6% 37,583,007 USC Class = ACE INHIBITORS, ACE INHIBITORS OTHER, ACE INHIBITORS WITH DIURETICS, ACE INHIBITORS, ALONE, ALPHA BLOCKERS ALONE & COMBO, ANGIOTENSIN II ANTAGONIST, ALONE, ANTIHYPERTENSIVES, OTHER, CALCIUM CHANNEL BLOCKERS, SELECTIVE ALDOSTERONE RECEPTOR INHIBITOR 8
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