Measuring Generic Efficiency in Part D

Measuring  Generic  Efficiency  

in  Part  D  

Generic  Efficiency  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  Generic  Efficiency  Rate  by  Therapeu;c  Area:  LIS  vs.  Non-­‐LIS  

96.5%  

94.6%  

99.9%  

98.0%  

99.1%  

96.3%  

94.5%  

99.9%  

98.8%  

99.4%  

0%  

10%  

20%  

30%  

40%  

50%  

60%  

70%  

80%  

90%  

100%  

Hypertension  

Epilepsy  

Dyslipidemia  

An=psycho=cs  

An=-­‐Depressant  

Generic  Efficiency  Rate  

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Non-­‐LIS  

LIS  

Generic  Fill  Rates  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  Generic  Fill  Rate  by  Therapeu;c  Area:  LIS  vs.  Non-­‐LIS  

89.9%  

93.6%  

76.8%  

32.7%  

81.2%  

88.6%  

95.5%  

73.5%  

36.1%  

82.6%  

0%  

10%  

20%  

30%  

40%  

50%  

60%  

70%  

80%  

90%  

100%  

Hypertension  

Epilepsy  

Dyslipidemia  

An=psycho=cs  

An=-­‐Depressant  

Generic  Fill  Rate  

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eu

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Non-­‐LIS  

LIS  

Generic  Efficiency  by  Therapeu;c  Area:  An;-­‐depressant  

All  Part  D

LIS

Non-­‐LIS

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)

*Total  Volume  =  volume  present  in  representative  SHA  PTD  Dataset  (2011)

Generic  Efficiency

LIS  Share  of  Part  D  Prescriptions

Generic  Efficiency

Generic  Fill  Rate

Generic  Efficiency  by  Therapeu;c  Area:  An;psycho;c  

All  Part  D

LIS

Non-­‐LIS

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

*Total  Volume  =  volume  present  in  representative  SHA  PTD  Dataset  (2011)

Generic  Efficiency

LIS  Share  of  Part  D  Prescriptions

Generic  Efficiency

Generic  Fill  Rate

Generic  Efficiency  by  Therapeu;c  Area:  Dyslipidemia  

All  Part  D

LIS

Non-­‐LIS

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

*Total  Volume  =  volume  present  in  representative  SHA  PTD  Dataset  (2011)

Generic  Efficiency

LIS  Share  of  Part  D  Prescriptions

Generic  Efficiency

Generic  Fill  Rate

Generic  Efficiency  by  Therapeu;c  Area:  Epilepsy  

All  Part  D

LIS

Non-­‐LIS

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

*Total  Volume  =  volume  present  in  representative  SHA  PTD  Dataset  (2011)

Generic  Efficiency

LIS  Share  of  Part  D  Prescriptions

Generic  Efficiency

Generic  Fill  Rate

Generic  Efficiency  by  Therapeu;c  Area:  Hypertension  

All  Part  D

LIS

Non-­‐LIS

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,  

Generic  Efficiency

LIS  Share  of  Part  D  Prescriptions

Generic  Efficiency

Generic  Fill  Rate

ˆ

 

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