The HHS Inspector General says Part D beneficiaries are far less likely than Medicaid beneficiaries to use lower-cost authorized generic versions of HCV drugs Epclusa (pictured above) and Harvoni.

Medicare and Hep C Patients Would Save Over $100 Million if Plan Sponsors Adopted Generic Use, OIG Finds

Medicare Part D beneficiaries were much less likely to use lower-cost, authorized generic versions of highly expensive hepatitis C drugs Harvoni and Epclusa in 2019 and 2020 than Medicaid beneficiaries, driving up costs for Part D enrollees and the Medicare program, a government watchdog agency says in a new report.

The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) attributed the difference in brand versus generic use primarily to the lack of inclusion of authorized generic versions of these drugs on the formularies of nearly half of Part D plans that covered the brand name version. More widespread coverage of brand name versions is due in part to the typically higher rebates paid by manufacturers to pharmacy benefit managers in exchange for favorable formulary placement of higher-cost drugs, the researchers say.

Medicare Part D beneficiaries were much less likely to use lower-cost, authorized generic versions of highly expensive hepatitis C drugs Harvoni and Epclusa in 2019 and 2020 than Medicaid beneficiaries, driving up costs for Part D enrollees and the Medicare program, a government watchdog agency says in a new report.

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