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Expand chart
Adapted from Dusetinza, et. al, 2019, "Sending The Wrong Price Signal: Why Do Some Brand-Name Drugs Cost Medicare Beneficiaries Less Than Generics?"; Chart: Andrew Witherspoon

Seniors who use generic specialty drugs may end up spending more out-of-pocket than those who use the brand version because of how Medicare's prescription drug benefit is structured, according to a new study in Health Affairs.

The bottom line: "If you need a lot of drugs or some very expensive drugs you would save more money out-of-pocket by using brands instead of generics," tweeted one of the study's authors, Stacie Dusetzina.

Details: The problem is most acute for specialty drugs, which tend to be the most expensive on the market.

  • Branded drug companies pay discounts in Medicare's "donut hole," which count toward that senior's overall out-of-pocket spending. Generics don't, so it takes longer for seniors using those drugs to spend enough for the government to start picking up more of their costs.
  • While Congress fixed the problem for biosimilars (akin to the generic version of biologics) last year, it left traditional small-molecule drugs unaddressed.

By the numbers: Even where competition among drugs is robust, patients whose prescriptions cost between $22,000 and $80,000 per year would save money if they used brand-name drugs instead of generics, the study found.

  • Part D plans may cover either the brand or the generic version of a drug, meaning patients can't switch between them even if they could get a better deal.

What they're saying: "We need to redesign [Part D] to work for people needing high-priced drugs. All of them. And we need to make generics CONSISTENTLY less expensive for patients than brands," Dusetzina tweeted.

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Trump impeachment trial to start week of Feb. 8, Schumer says

Senate Majority Leader Chuck Schumer. Photo: The Washington Post via Getty

The Senate will begin former President Trump's impeachment trial the week of Feb. 8, Majority Leader Chuck Schumer announced Friday on the Senate floor.

The state of play: Schumer announced the schedule after reaching an agreement with Republicans. The House will transmit the article of impeachment against the former president late Monday.

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CDC extends interval between COVID vaccine doses for exceptional cases

Photo: Joseph Prezioso/AFP via Getty

Patients can space out the two doses of the coronavirus vaccine by up to six weeks if it’s "not feasible" to follow the shorter recommended window, according to updated guidance from the Centers for Disease and Control and Prevention.

Driving the news: With the prospect of vaccine shortages and a low likelihood that supply will expand before April, the latest changes could provide a path to vaccinate more Americans — a top priority for President Biden.