Uptake of Generic vs Brand Name Immunosuppressants Among US Organ Transplant Recipients

After an organ transplant, a transplant recipient must take immunosuppressive medications to reduce the risk of their body rejecting the transplanted organ. Although using therapeutically equivalent generic medications can reduce financial burden, the transplant community has expressed caution about substituting these for brand-name immunosuppressants.

The researchers of the Transplant Outcomes Using Generic and Brand Name Immunosuppressants (TOGBI) study aimed to describe the rate of uptake of generic immunosuppressant medications. They used US Medicare Part D and Colorado pharmacy data to study kidney, liver, and heart transplant recipients from 2008-2013. The focus was on the two most commonly used immunosuppressants: tacrolimus (TAC) and mycophenolate mofetil (MMF).

Investigators found that in 2010, one year after the generic versions of these drugs became available nationally, generic TAC was dispensed over half of the time and generic MMF was dispensed over 70% of the time. By the end of the study in December 2013, generic TAC and MMF were dispensed almost 80% and 90% of the time.

Investigators also found different rates of generic substitution across states. For example, Colorado had a faster uptake of generic immunosuppressant medications compared with most other areas. Overall, these generic prescriptions have rapidly increased since market entry, exceeding the number of brand-name prescriptions by 2013 in all states.

“The fast uptake and high proportions of generic immunosuppressants described in this study imply a widespread impact of generic substitution, including potential cost savings to payers and patients” corresponding author Jarcy Zee noted, “High variability in generic uptake rates across states may indicate differences in socioeconomic status of organ transplant recipients, access to health care, and/or payer behavior. This study motivates further research in generic vs. brand-name immunosuppressant costs and patient outcomes for organ transplant recipients.”

The potential cost savings to both the patient and payer may be an incentive to choose generic immunosuppressant medications. For transplant patients, increased use of lower-cost generics may improve their medication access and result in more patients taking these medicines as prescribed.

 

CITATION:

Liu Q, Smith AR, Park JM, Oguntimein M, Dutcher S, Bello G, Helmuth M, Turenne M, Balkrishnan R, Fava M, Beil CA, Saulles A, Goel S, Sharma P, Leichtman A, Zee J. The adoption of generic immunosuppressant medications in kidney, liver, and heart transplantation among recipients in Colorado or nationally with Medicare part D. American Journal of Transplantation. 2018 Mar 31.

 View PubMed entry 
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August 27, 2018
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