Most patients whose physicians insist on prescribing a brand-name drug rather than a generic are unlikely to fill the more costly prescription, diminishing treatment outcomes and adding $7.7 billion to the nation’s annual care bill, a research study shows.
Approximately 5 percent of prescriptions submitted by CVS Caremark Pharmacy Benefit Management members in a 30-day period during 2009 included a “dispense as written” (DAW) designation from physicians, the study found.
This practice costs the health care system up to $7.7 billion annually, according to a new study by researchers at Harvard University, Brigham and Women’s Hospital in Boston and drug chain CVS Caremark.
Moreover, these requests reduce the likelihood that patients actually fill new prescriptions for essential chronic conditions, the researchers said in the study published this week in the American Journal of Medicine.
They found that when starting new essential therapy, chronically ill patients with DAW prescriptions were 50 to 60 percent less likely to actually fill the more expensive brand name prescriptions than generics.
The study reviewed 5.6 million prescriptions adjudicated by CVS Caremark for two million patients from Jan. 1 to Jan. 31, 2009. The review found that 2.7 percent of those prescriptions were designated DAW by doctors, while another 2 percent were requested DAW by patients.
If existing safe and effective generic alternatives had been provided in place of those brand-specific prescriptions, patients would have saved $1.7 million and health plans would have spent $10.6 million less for the medications, the study found.
The researchers said that assuming a similar rate of DAW requests for the more than 3.6 billion prescriptions filled in the U.S. annually, patient costs could be reduced by $1.2 billion and overall health system costs could be reduced by $7.7 billion.
CVS said annual excess health care costs due to medication non-adherence in the U.S. have been estimated to be as much as $290 billion annually.
