Estimates of DPC Savings based 2017 Medicare Part D Spending on Generics
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Estimated 2019 Savings in Medicare Part D if Top 30 Generics Dispensed In-office at Near Wholesale Pricing
Assumes same number of units as dispensed in 2017,
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*Average spending per dosage unit reflects multiple routes of administration of the drug (e.g., intravenous, subcutaneous) which individually may have different unit pricing. Additional information regarding calculation of spending per unit can be found in the methodology document.data from: https://www.46brooklyn.com/part-d-ski-slope, https://data.medicaid.gov/Drug-Pricing-and-Payment/NADAC-National-Average-Drug-Acquisition-Cost-/a4y5-998d/data, and https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Information-on-Prescription-Drugs/MedicarePartD.html
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Summary and methodology: https://docs.google.com/document/d/1KTi8Kf0ujhP9nE1i2h6O5Y_ZDhvGN7fD0aFXpiZCRbQ/edit?usp=sharing
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Generic NameNumber of ManufacturersTotal Spending 2017 Total Dosage Units 2017Total Beneficiaries 2017Average Spending Per Dosage Unit (Weighted) 2017Median Part D Price Q1 2019NADAC Q1 2019Est of 2019 Spending at Median Part DEst of 2019 Spending at NADAC priceEstimated 2019 Savings with in-office dispense at NADAC pricingSavings %Estimated 2019 Savings with in-office dispense at NADAC pricing + 10%Savings %Savings / Benficiary / Yr @ NADACSavings / Benficiary / Yr @ NADAC +10%
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Levothyroxine Sodium6$836,125,143.042,296,290,9197,344,170$0.37$0.45$0.42$1,027,590,186$962,528,610$65,061,5766%-$31,191,285-3%$8.86-$4.25
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Atorvastatin Calcium16$771,312,399.912,737,530,90910,496,843$0.28$0.24$0.09$650,163,591$246,377,782$403,785,80962%$379,148,03158%$38.47$36.12
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Metoprolol Succinate12$656,607,708.261,333,051,2914,525,729$0.49$0.58$0.26$776,502,377$346,593,336$429,909,04155%$395,249,70851%$94.99$87.33
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Aripiprazole13$624,240,107.8794,568,457434,746$6.65$2.82$0.35$266,525,434$32,626,118$233,899,31788%$230,636,70587%$538.01$530.51
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Esomeprazole Magnesium6$589,154,422.53180,343,829802,776$3.30$1.57$0.33$283,139,812$59,513,464$223,626,34879%$217,675,00277%$278.57$271.15
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Imatinib Mesylate4$570,999,425.793,561,87010,720$195.29$74.94$9.83$266,926,533$35,013,182$231,913,35287%$228,412,03486%$21,633.71$21,307.09
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Rosuvastatin Calcium12$568,449,982.31493,600,6532,101,322$1.15$0.44$0.12$214,716,284$57,998,077$156,718,20773%$150,918,40070%$74.58$71.82
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Gabapentin30$490,953,982.583,554,496,8765,803,589$0.14$0.19$0.08$669,430,245$296,208,073$373,222,17256%$343,601,36551%$64.31$59.20
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Hydrocodone/Acetaminophen
19$489,195,862.682,076,383,9366,792,894$0.24
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Potassium Chloride23$486,997,102.761,167,926,4023,194,843$0.41$0.56$0.38$656,374,638$446,147,886$210,226,75232%$165,611,96425%$65.80$51.84
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Duloxetine HCl18$449,270,855.68478,855,4661,601,792$0.94$0.66$0.18$314,448,423$87,790,169$226,658,25472%$217,879,23769%$141.50$136.02
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Lidocaine13$433,236,677.97155,877,638538,011$3.27$1.36$0.93$212,305,342$144,654,448$67,650,89532%$53,185,45025%$125.74$98.86
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Omeprazole18$385,211,197.521,840,392,2116,777,370$0.21$0.22$0.09$411,020,927$159,500,658$251,520,26961%$235,570,20357%$37.11$34.76
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Tamsulosin HCl13$370,155,285.97966,580,1153,452,678$0.39$0.26$0.09$251,310,830$86,992,210$164,318,62065%$155,619,39862%$47.59$45.07
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Ezetimibe1$309,420,859.1355,042,280366,874$5.62$1.09$0.20$59,996,086$11,008,456$48,987,63082%$47,886,78480%$133.53$130.53
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Hydroxychloroquine Sulfate
12$303,545,452.47165,361,208411,171$1.84$1.42$0.37$234,812,916$61,183,647$173,629,26974%$167,510,90471%$422.28$407.40
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Metformin HCl ER15$320,121,157.19757,381,3601,388,746$0.60$0.13$0.06$94,672,670$45,442,882$49,229,78852%$44,685,50047%$35.45$32.18
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Pravastatin Sodium14$300,324,042.09759,804,0182,933,366$0.39$0.34$0.11$254,534,346$85,477,952$169,056,39466%$160,508,59963%$57.63$54.72
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Doxepin6$285,633,525.8481,198,333260,530$1.88$0.81$0.54$66,002,645$43,731,102$22,271,54334%$17,898,43327%$85.49$68.70
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Celecoxib15$280,711,544.97174,605,890855,257$1.61$1.07$0.38$185,955,273$65,477,209$120,478,06465%$113,930,34361%$140.87$133.21
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Amlodipine Besylate27$267,103,575.092,389,231,4628,301,105$0.11$0.11$0.02$254,851,356$39,820,524$215,030,83284%$211,048,77983%$25.90$25.42
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Diclofenac Sodium24$253,309,339.91489,208,1461,699,901$0.49$0.78$0.42$379,625,521$206,445,838$173,179,68446%$152,535,10040%$101.88$89.73
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Fentanyl7$252,974,509.9425,362,631343,536$9.87
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Omega-3 Acid Ethyl Esters6$241,677,230.43211,824,864320,741$1.14$0.90$0.26$190,642,378$55,074,465$135,567,91371%$130,060,46768%$422.67$405.50
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Memantine HCl20$234,510,771.03250,673,024608,610$0.94$0.59$0.11$146,643,719$27,574,033$119,069,68681%$116,312,28379%$195.64$191.11
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Clobetasol Propionate9$233,846,798.4784,816,083796,410$2.75$4.11$1.81$348,594,100$153,517,110$195,076,99056%$179,725,27952%$244.95$225.67
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Divalproex Sodium ER13$224,371,309.44145,762,847264,454$1.54$0.78$0.35$113,111,969$50,288,182$62,823,78756%$57,794,96951%$237.56$218.54
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Oxycodone HCl26$221,093,539.57738,985,5931,549,007$0.29
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Enoxaparin Sodium7$214,481,285.748,722,306373,449$24.88$16.30$11.57$142,173,595$100,942,007$41,231,58929%$31,137,38822%$110.41$83.38
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Simvastatin17$212,203,044.591,637,110,1435,850,101$0.13$0.15$0.04$245,566,521$72,032,846$173,533,67571%$166,330,39168%$29.66$28.43
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Losartan Potassium24$201,369,122.521,337,111,0854,798,605$0.15$0.15$0.04$196,109,626$53,484,443$142,625,18273%$137,276,73870%$29.72$28.61
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Rivastigmine2$200,753,095.8019,801,960101,662$10.15$4.12$2.20$81,612,364$43,536,024$38,076,34147%$33,722,73841%$374.54$331.71
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Lisinopril25$194,847,519.121,835,921,2687,670,944$0.11$0.13$0.03$229,490,158$61,197,376$168,292,78373%$162,173,04571%$21.94$21.14
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Pantoprazole Sodium23$192,517,664.01850,303,2193,621,449$0.23$0.20$0.06$170,060,644$51,018,193$119,042,45170%$113,940,63167%$32.87$31.46
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Morphine Sulfate ER10$192,165,469.63199,807,097429,695$0.96
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Clopidogrel Bisulfate16$184,304,707.28746,246,2982,918,751$0.25$0.15$0.06$111,936,945$44,774,778$67,162,16760%$62,684,68956%$23.01$21.48
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Valsartan17$179,671,179.76309,790,3301,048,488$0.58$0.52$0.33$159,542,020$100,681,857$58,860,16337%$48,791,97731%$56.14$46.54
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Bupropion XL11$172,554,075.12200,420,527777,647$0.87$0.79$0.33$157,330,114$65,136,671$92,193,44259%$85,679,77554%$118.55$110.18
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Metformin HCl23$166,871,651.972,590,863,1405,059,076$0.06$0.08$0.03$215,905,262$77,725,894$138,179,36764%$130,406,77860%$27.31$25.78
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Warfarin Sodium10$160,678,457.38688,373,8151,934,819$0.24$0.25$0.12$170,563,734$83,369,718$87,194,01751%$78,857,04546%$45.07$40.76
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Raloxifene HCl11$161,074,674.3666,143,749241,589$2.43$2.16$0.54$142,870,497$35,717,624$107,152,87375%$103,581,11073%$443.53$428.75
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Colchicine2$160,869,540.3531,185,163308,731$5.16$5.38$4.47$167,776,179$139,397,681$28,378,49917%$14,438,7319%$91.92$46.77
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Allopurinol11$151,624,825.04600,196,0481,875,461$0.26$0.25$0.10$147,048,032$60,019,605$87,028,42759%$81,026,46755%$46.40$43.20
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TOTALS$13,360,414,980.07$9,640,293,106.99$3,833,491,516.57$5,806,801,590.4260%$5,423,452,438.7656%
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Spending is
Spending is
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in billions of dollars2.51475531.5147553$19,040,000
savings at NDAC +10%
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Assuming Part D Spending on Generics is
$8.70
spent in 2016 on brands that have generics available
times cost
times more
$20,400,000
savings at NDAC
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$2.80
HHS estimated savings if generics substituted for brands
than cost
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$5.90
cost of the substituted generics if paid at Part D pricing
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60%
discount when bought wholesale
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$3.54wholesale discount
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$2.36
NADAC generic wholesale cost
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$6.34
Savings w/o rebates $8.7-$2.36
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$2.61
rebate (avg rebate 30% on branded drugs)
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$6.09
est. price with rebates
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$3.73
savings factoring in average 30% rebate
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The average rebate for brand drugs with rebates was 30% of gross drug cost.
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https://www.ahip.org/prescription-drug-rebates-and-part-d-drug-costs/
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Prednisolone Acetate2$147,767,869.8720,097,9771,586,414$7.36
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Latanoprost6$144,726,700.3933,032,1921,708,168$4.37
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Metoprolol Tartrate18$144,033,170.322,034,573,1154,412,120$0.07
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Quetiapine Fumarate17$138,908,960.82388,232,7701,074,816$0.37
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Montelukast Sodium28$137,208,575.72465,579,9142,142,124$0.30
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Divalproex Sodium13$132,637,582.84294,353,831437,359$0.41
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Donepezil HCl23$132,096,828.17349,284,4811,416,929$0.39
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Olmesartan Medoxomil2$131,714,181.7038,993,948199,210$3.40
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Valganciclovir HCl6$130,783,335.433,700,66021,394$36.67
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Ursodiol13$129,241,169.5743,071,26476,982$3.06
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Trazodone HCl8$128,158,470.47691,081,7612,564,234$0.19
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Mirtazapine15$122,465,733.63235,295,8501,212,203$0.54
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Carvedilol17$120,686,076.371,595,845,2332,965,242$0.08
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Fluocinonide13$117,738,448.7249,213,332433,194$1.80
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Tetrabenazine3$116,397,398.951,747,7992,638$66.36
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Doxycycline Hyclate22$115,751,840.41105,975,8992,572,936$1.15
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Dofetilide2$115,538,326.3720,771,76339,632$5.56
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Fenofibrate9$115,460,435.44137,422,495526,212$0.85
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Fluoxetine HCl18$113,156,300.80429,127,5351,266,054$0.28
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Enalapril Maleate10$112,345,107.37271,164,120700,498$0.41
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Escitalopram Oxalate24$111,759,915.40406,946,7101,679,154$0.28
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Sertraline HCl13$109,221,159.98641,383,7022,352,675$0.17
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Tramadol HCl12$107,805,253.251,204,282,0744,505,133$0.09
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Baclofen12$105,937,952.15403,501,7211,103,772$0.25
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Finasteride16$101,032,733.18346,621,6581,323,107$0.29
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Brimonidine Tartrate5$96,888,985.8914,753,119372,179$6.95
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Tizanidine HCl11$96,811,708.44394,014,0521,309,011$0.25
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Prednisone8$96,294,813.47512,308,5865,854,449$0.23
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Alprazolam13$95,055,966.00909,105,7442,629,453$0.11
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Oxybutynin Chloride7$94,340,026.99237,991,484656,154$0.41
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Hydrochlorothiazide22$93,563,234.571,012,437,1434,025,654$0.09
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Glimepiride13$91,447,632.50518,456,1331,326,711$0.17
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Polyethylene Glycol 33504$91,276,081.821,842,315,5751,322,866$0.22
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Clozapine4$90,836,252.8871,641,97664,646$1.33
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Calcipotriene8$90,255,507.0321,439,46273,268$4.12
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Amitriptyline HCl7$88,665,123.89235,254,045786,533$0.41
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