Dusetzina SB, Sarpatwari A, Carrier MA, et al. - For insulin and direct-acting antiviral agents, authorized generic drugs could reduce out-of-pocket expenditure for patients but are unlikely to offer savings for Part D plans or Medicare. Instead, due to these drugs, manufacturers are able to offer products at a lower list price without materially decreasing net prices or profits.

• This cross-sectional study of Medicare formulary and pricing data for quarter 3 of 2020 was performed to evaluate Medicare Part D formulary coverage for 4 brand-name formulations of insulin and direct-acting antiviral agents and their authorized generic formulations.

• The majority of Part D plans provided brand-name drug–only or both brand-name and authorized generic drug coverage.

• Compared with list prices for Epclusa, Harvoni, and each brand-name insulin product, the observed authorized generic drug list costs were 67%, 62%, and 50% lower, respectively.

• Authorized generic drug use among Medicare beneficiaries was associated with savings of $270 per year for 12 vials of Humalog and $2974 for a full course of Harvoni.

• However, plans have limited incentives to promote authorized generic drug use as rebates for brands probably exceed savings available with authorized generic drugs, especially for beneficiaries with expenditure that reaches the Medicare Part D coverage gap.