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Direct-to-Consumer Ads associated with
higher Medicaid Costs
Newswise — Direct-to-consumer advertising (DTCA)
for a commonly prescribed antiplatelet drug
does not appear associated with increased
use, but may be associated with increased
drug costs and Medicaid pharmacy
expenditures, according to a report in the
November 23 issue of Archives of Internal
Medicine, one of the JAMA/Archives journals.
“The cost of drugs to public and private
health insurance programs has been a
long-standing source of concern among policy
markers,” the authors write as background
information in the article.
Millions
of Americans are enrolled in publicly funded
Medicare Part D programs. In addition,
prescription drugs are cited as one of the
three top reasons for Medicaid expenditure
growth, and prescription drug costs have
increased by an average of 15.4 percent per
year between 1994 and 2004. Meanwhile,
spending for DTCA has increased more than
330 percent in the last 10 years.
Michael R. Law, Ph.D., of Centre for Health
Services and Policy Research, University of
British Columbia, Vancouver, Canada, and
colleagues studied the association between
DTCA and the use and cost of clopidogrel, a
commonly used and heavily marketed (as
Plavix) antiplatelet agent.
Researchers
examined pharmacy data from 27 state
Medicaid programs from 1999 to 2005. Changes
in the amount of units sold, costs per unit
and total pharmacy expenditures after DTCA
initiation were noted.
There was no DTCA for clopidogrel from 1999
to 2000. From 2001 to 2005, U.S. spending on
DTCA for clopidogrel exceeded $350 million,
an average of $70 million per year.
Clopidogrel use in the 27 Medicaid programs
did not change after DTCA. However, cost per
unit per quarter increased by $0.40 (12
percent) after DTCA for the drug began,
leading to an added $40.58 in pharmacy costs
per 1,000 Medicaid enrollees per quarter.
“Overall, this change resulted in an
additional $207 million in total pharmacy
expenditures,” the authors write.
“Consequently, payers and policy makers
should appropriately still be concerned
about DTCA increasing total drug costs for
publicly funded reimbursement programs such
as Medicaid and Medicare. Future
longitudinal studies should examine other
drugs and settings because many other
countries are currently considering whether
to permit DTCA,” the authors conclude
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