The Association for Accessible Medicines (AAM) has expressed disappointment over an analysis published by Avalere this week, which revealed that Medicare plans are increasing patients' costs for generic drugs. The AAM asserts that Medicare patients should not be excluded from the full savings provided by generics and biosimilars.

"Avalere's analysis demonstrates that fewer than half of all generic drugs are on generic formulary tiers," said David Gaugh, interim president and CEO. "Medicare Part D Plans continue to deny patients the full value of low-cost generic drugs. Plans are profiting from patients using generic drugs through higher copays and placement on brand formulary tiers, even as generic prices continue to fall. AAM encourages the Administration and Congress to ensure that Medicare beneficiaries receive the full value of low-cost generics."

According to a press release from the AAM, Avalere's analysis examined Plan D sponsors and the distribution of generic prescription drugs across different tiers from 2016 to 2024. The study found that Plan D sponsors placed a higher proportion of covered generic drugs on non-generic tiers over time. Furthermore, the analysis disclosed an increased percentage of generic medicines being placed on non-preferred tiers since 2016—a rise from 36% in 2016 to 56% in 2024, marking a significant 20% jump.

The AAM press release further highlighted that over the past decade, the use of generic drugs has saved patients and the U.S. healthcare system nearly $3 trillion. However, Medicare patients have not fully benefited from these savings. To encourage seniors enrolled in Medicare Part D plan to utilize the lowest-cost options, drugs are covered on formulary tiers, with lower-tiered drugs having lower copays than higher-tiered ones. For instance, a copay in the lowest tier might be $0 for preferred generics. Despite prices for generic medicines decreasing over recent years, many Medicare Part D plans continue to place generic drugs on higher tiers with more costly copays.

As stated in the AAM press release, AAM is an association committed to advocating for the generic drug market. It represents manufacturers and distributors of finished generic pharmaceuticals and biosimilars, manufacturers and distributors of bulk pharmaceutical chemicals, as well as providers of other goods and services to the generic industry.