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Open Access: This is an open access article distributed under the terms of the CC-BY License. doi: 10.1001/jamanetworkopen.2020.35064Ĭorrection: This article was corrected on February 12, 2021, to fix an error in the display of the subject heading. Policies that limit lock-step price increases, shorten patent durations, and encourage development of generic equivalents may mitigate rising drug prices.Īccepted for Publication: December 4, 2020. 5, 6 Therefore, the lock-step price increases of brand-name medications, without evidence of price competition, raise concerns and would be expected to adversely affect patient adherence to medications and thus clinical outcomes. Rebates, list prices, and net prices have been growing for brand-name medications, and rebate growth has been shown to positively correlate with list price growth, thereby impacting costs faced by patients paying a percentage of (or the full) list price. In addition, AWPs do not account for rebates, which are negotiated annually. Moreover, we did not investigate competition across drug classes, which may affect within-class price dynamics. For instance, our findings may not generalize to other drug classes. There are some limitations to our analysis. In fact, for 1 class, P2Y 12 inhibitors, the correlation between rising AWPs was higher when our analyses were restricted to the period prior to the market introduction of a within-class generic equivalent. 4 These results suggest there was little price competition among the sponsors of these products. Moreover, the median CAGR in costs for each of these medication classes outpaced annual growth rate of the consumer price index for prescription drugs at 2.1% over the same time period.
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This cross-sectional study found high correlations between AWPs among drugs within 5 classes used to treat chronic conditions that had multiple brand-name medications on the market contemporaneously from 2015 to 2020.
#RED BOOK DRUGS PRICE LIST SOFTWARE#
All analyses were performed using Stata statistical software version 15.1 (StataCorp) and Excel spreadsheet software version 14.7.6 (Microsoft). We additionally calculated CAGRs for brand-name medication costs within each class. Our primary outcome was the correlation in AWP unit prices among the multiple brand-name medications within each class available over time, measured using Kendall τ-b (τb) coefficient. For each medication, we selected the recommended maintenance dosage on the label, limiting to medications sold by the manufacturer that received initial Food and Drug Administration approval. There were multiple brand-name medications on the market contemporaneously in the following classes: direct oral anticoagulants (DOACs), sodium-glucose transport protein-2 (SGLT2) inhibitors, dipeptidyl peptidase-4 (DPP4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and platelet P2Y 12 inhibitors. We limited our study sample to brand-name medications used for chronic conditions available for purchase before January 1, 2018, to better characterize pricing trends for prescription medications used over a prolonged period. This study is reported following the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE) reporting guideline.
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3 The study did not require institutional review board approval or patient informed consent because it was based on publicly available information and involved no patient records. We conducted a cross-sectional study of per-pill average wholesale prices (AWPs) in the US from August 13, 2015, to August 13, 2020, obtained the Micromedex Red Book (IBM). Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.