Seniors Who Can Least Afford Brand Name Drugs Most Likely to Spurn Generics

Physicians need to prescribe lower cost generic drugs when available

October 13, 2006 – A new study, focusing on cardiovascular drugs, has found that senior citizens with the lowest incomes or no prescription insurance coverage are less likely than their more affluent contemporaries or those with prescription coverage to use generic drugs. The Mount Sinai School of Medicine researchers say physicians need to be more aggressive about prescribing generic drugs.

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The study, which appears in the October 2006 issue of The American Journal of Managed Care, is the first nationally representative study that examines the association of income and prescription drug coverage with generic medication use by Medicare beneficiaries.

The study is timely as more seniors fall into the no coverage gap of the Medicare drug program known as the "Donut Hole." Generics have also received added emphasis by the discounts on generics being offered by a number of pharmacies, including Wal-Mart, which offers a list of generic drugs at $4 for a 30-day supply.

"Since the implementation of the new Medicare prescription drug benefit, the burden of navigating benefit waters to realize savings on medications has fallen mainly on seniors" says Alex D. Federman, M.D., M.P.H, Assistant Professor of Medicine at Mount Sinai School of Medicine and lead author of the study.

"One obvious cost-saving approach is the use of generic medications."

Dr. Federman and colleagues examined generic cardiovascular drug use in a nationally representative sample of elderly Medicare beneficiaries with hypertension. Hypertension was chosen as a model of chronic disease because of its high prevalence in the United States, the wide availability of generic cardiovascular drugs, and the large prescription drug expenditures associated with this condition.

The findings showed that older patients with cardiovascular diseases often used costly brand name drugs when equivalent but lower cost generic versions are available.

"The patients that we were concerned about are low-income and underinsured seniors. Our findings show this group in-particular are missing opportunities to save money on prescription drugs without sacrificing quality of care," noted Dr. Federman.

"Physicians must take an active role to address this problem by prescribing equivalent, lower cost generic versions when available."

Editor's Notes:

Funding for this study was made possible by a grant from the Robert Wood Johnson Generalist Faculty Scholars Programs. The MSSM research team included Ethan Halm, M.D., M.P.H; Carolyn Zhu, Ph.D.; Tsivia Hochman, MA; and Albert L. Siu, M.D., M.S.P.H.

Mount Sinai School of Medicine

Located in Manhattan, Mount Sinai School of Medicine is internationally recognized for ground-breaking clinical and basic-science research, and innovative approaches to medical education. Through the Mount Sinai Graduate School of Biological Sciences, Mount Sinai trains biomedical researchers with an emphasis on the rapid translation of discoveries of basic research into new techniques for fighting disease.

One indication of Mount Sinai's leadership in scientific investigation is its receipt during fiscal year 2005 of $174.1 million in research support from the NIH. Mount Sinai School of Medicine also is known for unique educational programs such as the Humanities in Medicine program, which creates opportunities for liberal arts students to pursue medical school, and instructional innovations like The Morchand Center, the nation's largest program teaching students and physicians with "standardized patients" to become not only highly skilled, but compassionate caregivers. Long dedicated to improving its community, the School extends its boundaries to work with East Harlem and surrounding communities to provide access to health care and educational programs to at risk populations.