(0109) Potential Medicare Savings on Drugs Commonly Prescribed by Otolaryngologists Through a Low-Cost Generic Drug Program

Introduction: Low-cost generic drug programs, such as the Mark Cuban Cost Plus Drug Company (MCCPDC), have recently launched to reduce financial burden on patients and insurers. We sought to investigate the potential savings if Medicare Part D plans secured MCCPDC pricing for drugs commonly prescribed by otolaryngologists.

Methods: Our analysis included drugs that met three criteria: (1) 2021 unadjusted Medicare Part D spending on prescriptions by otolaryngologists ≥ $500,000; (2) single dosage unit type; (3) available within MCCPDC formulary as of December 2023. For each included drug, we calculated the MCCPDC per unit dose price and - using the 2021 Medicare Part D Spending Dashboard – extracted the total number of dispensed dosage units, Medicare per unit dose price, and total spending. We used descriptive statistics to compare per unit dose prices and estimated potential savings as the per unit dose price difference between Medicare/MCCPDC multiplied by total dosage units. We adjusted 2021 Medicare data for inflation to reflect December 2023 USD.

Results: Our analysis included 16 generic prescription drugs with adjusted Medicare Part D spending totaling $4.7 billion dollars in 2021. Under MCCPDC pricing, Medicare Part D plans would have saved $2.9 billion dollars (relative reduction: 62.3%). Median per unit savings would have been -65.7% (interquartile range: -42.6% to -81.4%); on a per unit basis, savings would have been greatest for tobramycin-dexamethasone (-94.3%), ciprofloxacin-dexamethasone (-89.7%) and budesonide-formoterol (-84.2%). Median total savings would have been $28.7 million (interquartile range: $18.7 million to $99 million); total savings would have been greatest for budesonide-formoterol ($1.9 billion), dexlansoprazole ($464.6 million) and levothyroxine ($327.4 million).

Conclusions: Many drugs commonly prescribed by otolaryngologists are available via a low cost generic drug program. Otolaryngologists and insurers should consider utilizing such programs to reduce the financial burden of prescription drugs on Medicare beneficiaries.