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S3, Ep 2- A Failed Promise: Why Are Patients Overpaying for Generic Medications?

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Healthcare Matters

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In the United States, nine out of 10 prescriptions issued are for generic, instead of brand-name medications.

While Pharmacy Benefit Managers negotiate drug prices on behalf of Americans, an increasing number of patients are choosing to bypass these intermediaries – as well as their insurance – altogether and pay for prescription drugs in cash instead. “Generics are supposed to be very low-cost alternatives to brand-name medicines, but you'd be surprised to hear what's going on here,” says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation.

“We need to become better consumers of health care. We are patients, but we need to also become consumers just like the way we consume anything. We need to become better at it,” says Dr. Popovian.

Among the highlights in this episode:

1:36: 92% of all prescriptions dispensed in the U.S. are for generic medicines as opposed to only 8% of prescriptions for brand-name medicines

2:45: Patients bypassing their insurance to buy their prescription medicines: the role of cash pharmacies

4:13: What is ‘spread pricing’?

5:18: A study published by The Schaeffer Center at University of Southern California found that patients overpay for their prescription about 25% of the time

6:58: What are Pharmacy Benefit Managers (PBM) and what is their role in the health care system?

8:54: Dr. Popovian gives a personal anecdote of how it can be cheaper to pay in cash for a medical exam rather than paying via an insurance plan

10:10: A few tips on things patients should consider in order to pay less for their medications and other medical expenses

11:25: The Federal Trade Commission is conducting an inquiry into the competitive impact of contracting and other business practices of PBMs

13:04: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: cmertens@ghlf.org

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to healthcarematters@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

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