Availability and Pricing of Drugs Prescribed by Otolaryngologists Through a Direct‐to‐Consumer Pharmacy: Medicare Savings Implications
High prescription drug prices can financially strain patients and insurers, with substantial clinical repercussions. In recent years, direct-to-consumer (DTC) pharmacies have emerged as potentially lower-cost alternatives for patients to fill prescriptions. We evaluated whether drugs commonly prescribed by otolaryngologists were available at a national DTC pharmacy (Mark Cuban Cost Plus Drug Company [MCCPDC]) and estimated potential Medicare savings from DTC pricing. We identified drugs and prices paid by Medicare Part D plans using the 2021 Drug Spending Dashboard. Our analysis included 16 generic drugs within the MCCPDC formulary, which offered lower prices for 14 (87.5%) drugs. If plans had secured MCCPDC pricing for all 16 drugs, Medicare patients and plans would have saved $2.9 billion (relative reduction: 62.3%) in 2021. Estimated total savings were greatest for budesonide-formoterol ($1.9 billion), dexlansoprazole ($464.6 million), and levothyroxine ($327.4 million). Otolaryngologists and insurers may consider utilizing DTC pharmacies with lower drug prices, though patients may face challenges projecting out-of-pocket costs across pharmacies, medications, benefit phases, and formulary tiers.
Authors
- Vinay K. Rathi (ORCID: https://orcid.org/0000-0002-9763-9075)
- Alan D. Workman (ORCID: https://orcid.org/0000-0001-9573-6472)
- Steven D. Pletcher (ORCID: https://orcid.org/0000-0003-0127-927X)
- Taylor Standiford (ORCID: https://orcid.org/0000-0001-5289-4251)
- Rodney J. Schlosser (ORCID: https://orcid.org/0000-0001-6480-0275)
- Zachary M. Soler (ORCID: https://orcid.org/0000-0002-4304-595X)
Institutions
- Massachusetts Eye and Ear Infirmary (US)
- Medical University of South Carolina (US)
- University of California, San Francisco (US)
- The Ohio State University Wexner Medical Center (US)
- Ralph H. Johnson VA Medical Center (US)
Publication Details
- Journal
- Otolaryngology
- Published
- 2024-10-16
- DOI
- https://doi.org/10.1002/ohn.1023
- Citations
- 1
- Primary Topic
- Pharmaceutical Economics and Policy
- Type
- article
- Field-Weighted Citation Impact
- 1.13