Purchasing prescription drugs in a three-month supply rather
than a one-month supply has long been regarded as a way to reduce
the cost of drugs for patients and third-party payers. New research
from the University of Chicago quantifies the savings for the first
time.
An analysis of 26,852 prescriptions filled for 395 different
drugs from 2000-2005 showed that patients who purchased their drugs
in three-month supplies rather than with one-month supplies saved
on average 29% in out-of-pocket costs. After factoring in
third-party payers, including Medicare, Medicaid and insurance
companies, total savings averaged 18%.
"These savings may not seem large to some, but they could help
trim the cost of health care, which is especially important given
the nationwide debate about how to finance health care reform,"
said G. Caleb Alexander, MD, MS, Assistant Professor of Medicine at
the University of Chicago Medical Center and senior author of the
study, which will be published in print November 20, 2009, in
Applied Health Economics & Health Policy.
Although prescription drug costs represent only about 10% of the
nation's total health care bill, they are one of the fastest
growing sectors and affect a large proportion of patients.
"No matter what any health care reform package looks like,
millions of Americans are burdened by prescription drugs costs, and
this is one important way to help relieve that burden," Alexander
said. "Other methods to lower prescription drug costs include
substituting generic drugs for brand-name drugs and discontinuing
non-essential medicines."
The drugs in this study were limited to those that were
prescribed for common chronic conditions, including high
cholesterol, hypertension, hypothyroidism and depression. Only
patients who received both a one-month supply and a three-month
supply during the same year in the same dose and quantity were
included in the main analyses.
Forty-four percent of the prescriptions examined were dispensed
in three-month supplies; the remainder were dispensed in one-month
supplies. "This indicates that there is a significant amount of
cost savings yet to be realized by converting from one-month
supplies to three-month supplies," Alexander said.
The average monthly out-of-pocket cost for a one-month supply
was $20.44 compared with $15.10 for a three-month supply yielding a
29% savings after adjustment for potential confounders. The
corresponding numbers for the average monthly total costs were
$42.72 and $37.95, respectively, yielding an 18% savings after
adjustment for potential confounders.
If all the drugs in the study had been provided as three-month
supplies, the out-of-pocket savings would have amounted to an
estimated $148.6 million. Total savings would have amounted to
$245.1 million. All figures are in 2005 dollars.
Patients' sex, race, level of education and number of chronic
conditions did not seem to predict who was most likely to fill a
3-month supply, Alexander said. "We were surprised to find that
there were no substantial systematic differences in the
characteristics of individuals filling one-month and three-month
supplies."
"Patients who are paying a lot each month for
medicines—especially to treat chronic conditions—should
investigate whether they can save money by using a three-month
supply," he said. "Physicians need to keep this in mind as a potent
way to help patients afford their medications."
SOURCE