For many patients with chronic health conditions, remembering to take multiple drugs throughout the day can make the difference between life and death.
It’s no wonder, then, that doctors might suggest a simple alternative: taking all medications at once, rolled into 1 convenient tablet. This may explain why Medicare, responsible for 30 percent of prescription drug spending in the U.S., spent $303 Million on these so-called brand-name combination pills in 2016.
Yet according to new research, patients and the public could have spent a staggering $68 Million less on separate generic alternatives.
Comparing the Costs of Combo Pills
Brand-name combo pills do have their advantages, on the surface. Rather than risk forgetting to take a pill, you simply take both at once to ensure you get the medicines you need.
Alone, these individual medicines don’t cost much. But here’s the caveat: By combining drugs, pharma companies can slap them with price tags of hundreds if not thousands of dollars.
For example, according to Axios:
- Duexis, made of ibuprofen and famotidine, costs $2,482 for a 90-pill bottle
- Vimovo, made of Aleve and Nexium, costs $2,482 for a 60-pill bottle
- Treximet, made of Sumatriptan and Naproxen, costs $880 for a 9-pill bottle
- Caduet, made of Lipitor and Norvasc, costs $580 for a 30-pill bottle
Each of these drugs is made up of medications that can be bought over the counter for $20 or less. And despite their higher costs, experts say, combo pills don’t actually work better.
According to Dr. Chana Sacks of Brigham and Women’s Hospital, which this month published a study on combo pills:
“These brand-name combination pills cost far more than the sum of their parts. The price of brand-name combination drugs, like all medications in the U.S., are not determined based on the magnitude of the clinical benefit or the costs of research and development; rather prices are set by the manufacturer based on what the market will bear.”
Medicare Spending Goes through the Roof
For their study, Brigham and Women’s researchers collected data from 2011 to 2016 on 1,500 total medicines, including 29 brand-name combo pills with generic alternatives available.
For the 10 most expensive among these, researchers estimated, Medicare could have spent a total $2.7 Billion less by prescribing generic alternatives instead. That includes the $68 Million it could have saved on identical doses of generics, $13 Million on generic drugs at different doses, and other prescriptions Medicare could have considered.
Researchers also looked at each drug in turn. Epzicom, a combination of abacavir and lamivudine used to treat HIV, racked up $106 Million of excess Medicare spending, for example. Percocet, an opioid containing oxycodone and acetaminophen, resulted in excess spending of $42.8 Million.
“Medicare reported spending more than $14 for each dose of brand-name Percocet,” Sacks said, “despite the existence of a generic combination oxycodone/acetaminophen product.”
Combo Pills Only Part of Big Pharma’s Profit-Driven Agenda
Researchers lacked data on why combo pills were prescribed, but supposed there may be legitimate reasons. Individual drugs aren’t always available in the doses combination products offer. In these cases, it can be harder for patients to find substitutes.
The real controversy, however, is that combo pills could drive up already-exorbitant healthcare spending.
Since President Trump’s recent speech about hazy plans to lower drug prices, drug companies and pharmacy benefit managers have been at odds over who caused the nation’s soar in excessive and inexplicable drug spending. Pharmacy benefit managers blame drug companies’ aggressive price points, while drug companies (and Trump) claim other countries extort Big Pharma so their citizens pay less than Americans.
But if 1 thing was clear from Trump’s plan, it’s that Big Pharma has once again succeeded in lobbying the administration to take it easy on their profits – no matter the cost to the American people. Aware that patients with serious illnesses will pay whatever they need to pay to manage their illness, pharma companies jack up the prices for specialty drugs – combo pills among them.
In public, of course, combo drugmakers refute that profits come first. Caduet manufacturer Pfizer responded to the study with: “This is a question of patient choice. Comparing the price of a branded combination medicine to individual generics is apples to oranges.”
Experts draw a very different comparison: that combo pills are nowhere near worth the inconvenience of swallowing more than 1 pill.
“This benefit can be quickly erased if patients have a hard time affording the combination product,” Dusetzina said. “For patients who are using a combination product and finding that they are not affordable, they should ask their pharmacist if there is a cheaper option.”
Be sure to speak to your doctor or pharmacist before switching or stopping drugs.