TY  - JOUR
T1  - Generic competition in a flawed system: Pill them, bill them—reply
AU  - Downing NS, Ross JS, Krumholz HM
Y1  - 2012/10/22
N1  - 10.1001/2013.jamainternmed.806
JO  - Archives of Internal Medicine
SP  - 1522
EP  - 1523
VL  - 172
IS  - 19
N2  - 
Hay questions whether consumers were actually harmed by Abbott's branded reformulations of fenofibrate, suggesting that Abbott likely offered rebates and discounts to payers in an effort to improve formulary position. Our article included an analysis of wholesale prices for fenofibrate that showed that Abbott's branded reformulations were twice as costly as generics.1 Given this difference in price, generic fenofibrate almost certainly would be listed on a more favorable formulary tier than branded versions, even if Abbott was offering significant rebates or discounts. Thus, patients who continued to use branded fenofibrate likely faced higher copayments than those using generic formulations. In addition, the continued use of branded formulations likely increased overall health care costs, which impose indirect costs on patients through higher insurance premiums. Hay also draws attention to the findings of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, which showed that fenofibrate did not reduce cardiovascular risk when added to statin therapy.1 We agree that the broad use of fenofibrate, especially the more costly branded reformulations, should be re-evaluated in light of this study.

SN  - 0003-9926
M3  - doi: 10.1001/2013.jamainternmed.806
UR  - http://dx.doi.org/10.1001/2013.jamainternmed.806
ER  -