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.

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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
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article

Availability and Pricing of Drugs Prescribed by Otolaryngologists Through a Direct‐to‐Consumer Pharmacy: Medicare Savings Implications

Vinay K. Rathi, Alan D. Workman, Steven D. Pletcher, Taylor Standiford et al.
1 citations
Otolaryngology
Pharmaceutical Economics and Policy
1.13
article

Availability and Pricing of Drugs Prescribed by Otolaryngologists Through a Direct‐to‐Consumer Pharmacy: Medicare Savings Implications

Vinay K. Rathi, Alan D. Workman, Steven D. Pletcher, Taylor Standiford, Rodney J. Schlosser, Zachary M. Soler
article en
1 citations

Abstract

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.

OtolaryngologyVol. 172(1)
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)
Openalex Percentile: Top 11%
Pharmaceutical Economics and Policy
1.13
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Availability and Pricing of Drugs Prescribed by Otolaryngologists Through a Direct‐to‐Consumer Pharmacy: Medicare Savings Implications — Vinay K. Rathi, Alan D. Workman, et al. · Otolaryngology (2024) | TGRS Research Map | TGRS