By taking a page out of Mark Cuban’s playbook, insurers that operate Medicare Part D plans could save taxpayers more than $2 billion every year, according to a new analysis.
Published in the Journal of Clinical Oncology, the paper suggests these insurers could put between $228 million and $2.15 billion back in taxpayers’ pockets by purchasing a series of generic oncology medications at the same prices obtained by the Mark Cuban Cost Plus Drug Company (MCCPDC).
The study, which was led by Ruchika Talwar, a urologic oncology fellow at Vanderbilt University Medical Center, tested the hypothesis that Part D plan sponsors and their beneficiaries are likely overpaying for these drugs.
Talwar suggested that these findings are “of utmost importance.”
“Both doctors and patients should be aware of cash-pay options available that might offer lower prices to beneficiaries purchasing outside of their health plans and the impact that this drug price stewardship could have on Medicare and Part D sponsors,” Talwar said.
The team arrived at their conclusion after comparing the 2020 Medicare Part D Spending dashboard, Q3-2022 Part D formulary prices and Q3-2022 MCCPDC prices for seven self-administered generic oncology drugs—abiraterone, anastrozole, imatinib, letrozole, methotrexate, raloxifene and tamoxifen. Savings were estimated by replacing Q3-2022 Part D unit costs with the MCCPDC plan’s costs for the drugs.
The median savings were estimated as follows:
abiraterone, $338.0 million
anastrozole, $1.2 million
imatinib 100 mg, $15.6 million
imatinib 400 mg, $212.0 million
letrozole, $1.9 million
methotrexate, $26.7 million
raloxifene, $63.8 million
tamoxifen, $2.6 million
For individuals taking abiraterone (Zytiga), this would translate into $25,200 in savings per year, and between $17,500 and $20,500 per year for those who are prescribed imatinib (Gleevac).
Study co-author Stacie Dusetzina, PhD, a professor of health policy at the Wharton School of Business, said the findings suggest some Part D plans and their benefits managers “aren’t doing a good enough job at getting favorable prices.”
The group added that MCCPDC is one of a growing number of companies that have set out to address the issue of overpriced generic drugs. They expressed optimism that continuing to raise awareness of the MCCPDC mission will hopefully improve access to vital medications in the future.
The study abstract is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.