Generics prescribed most in U.S.

June 13, 2010
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It may come as a surprise to those who watch a lot of network television that neither Viagra nor Cialis were among the nation’s most-prescribed drugs in 2008.

In fact, neither made the list of the 50 most-prescribed drugs for that year, despite the numerous television ads that ran for the erectile dysfunction medications.

A generic pain reliever, hydrocodone, topped the list with 121.3 million prescriptions. But Lipitor, a brand-name drug prescribed for high cholesterol, topped the revenue chart with a take of $5.88 billion from only 49.3 million prescriptions — less than half the number filled for hydrocodone, which netted a comparatively meager $1.78 billion.

All totaled, Americans spent $53.2 billion on the 50 most-prescribed drugs in 2008, according to data compiled from multiple sources by AARP. Of that amount, nearly $33 billion was spent on brand-name drugs, even though only 11 brand names were on the list. (See related chart.) 

“The trend toward generics has been increasing probably over the last 10 years. So what you see on this 50 most-prescribed list has been very commonly seen over the last couple of years,” said Karen Jonas, a pharmacist and director of professional practice for the Michigan Pharmacists Association. “But the numbers continue to grow as far as generic utilization, and that’s a good thing.”

Why is it a good thing?

“Because the generic medications are just as effective in treating medical conditions as their brand-name counterparts, but obviously offer more economical costs for the patient. And really in these economic times, people need to try to find an option to save dollars and still get appropriate medical care. So we are seeing a lot more patients turning to the generic medications,” said Jonas.

The list revealed four major categories of medications, and a review showed that many Americans had high cholesterol, were depressed and experienced physical pain. Plenty also suffered from hypertension. Nine drugs for hypertension made the top 50 list with 320.4 million prescriptions filled, the most of any category.

“There is a high percent of hypertension throughout the country, but Michigan has a high incidence of cardiovascular disease. We’re just not as healthy a state as other states are, so it’s not surprising the numbers that are on the list,” said Jonas from her office in Lansing.

Six pain drugs were on the list at 235.4 million prescriptions and $3.98 billion, the least spent in the four categories. Eight drugs were listed for depression with 193.5 million prescriptions and $7.29 billion in spending, the second highest of the four categories.

Only four drugs for high cholesterol made the list at 139.6 million prescriptions, the fewest of the four largest prescribed categories. But these four drugs grossed the highest spending at $9.38 billion. Two of the four — Lipitor and Crestor — are brand names and together were worth $7.56 billion or 80 percent of the category’s total.

But the higher cost of brand-name drugs wasn’t the only reason so much money was spent in this category.

“Treatment for cardiovascular diseases, as well as diabetes, includes these medications. Again, in Michigan, we have a high incidence of cardiovascular disease and a high incidence of diabetes. So it’s not surprising that we’d see a high percent (of spending) in this state, as well as nationally,” said Jonas, who added the percentage could drop in the next list because Lipitor is now available generically.

When a drug like Lipitor goes generic, it is good news for consumers because of the lower price. But a pharmacist cannot make the change from name brand to generic without the doctor’s permission.

“Whenever a patient has a question like that or whenever a generic of that name brand is available, a pharmacist must call and talk with the physician before making a change like that. They always have to confer with a physician, and a physician always has to agree to any kind of change to a prescription,” said Jill Cobb, MPA director of communications.

“Because pharmacists are so knowledgeable about what drugs are out there and what generics are available, they are able to help a patient get the best affordable price for the therapy that they need.”


Editor’s note: To see the 50 most prescribed drugs in the U.S. ranked by the number of prescriptions that were filled in 2008, see the June 14 Business Journal’s online edition at www.grbj.com.

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