Other Countries Rate Half of Top-Selling Drugs in Medicare as Low Added Benefit

Apr 28, 2023

THURSDAY, April 27, 2023 (HealthDay News) — Many of top-selling drugs in Medicare in 2020 received low added-benefit ratings by the national health technology assessment (HTA) organizations in Canada, France, and Germany, according to a study published in the April 18 issue of the Journal of the American Medical Association.

Alexander C. Egilman, from Brigham and Women’s Hospital in Boston, and colleagues examined the added therapeutic benefit of the 50 top-selling brand-name drugs in Medicare in 2020 based on HTA organizations in Canada, France, and Germany.

The researchers report that 49 drugs (98 percent) received an HTA rating by at least one country. A low added-benefit rating was received by 22 of 36 drugs (61 percent) in Canada, 34 of 47 in France (72 percent), and 17 of 29 in Germany (59 percent). More than half of the drugs (27) had a low added therapeutic rating across countries. These low added therapeutic-rating drugs accounted for $19.3 billion in annual estimated net spending, or 35 percent of Medicare net spending on the 50 top-selling single-source drugs and 11 percent of total Medicare net prescription drug spending in 2020. Drugs with a low added therapeutic rating were used by more Medicare beneficiaries (median, 387,149 versus 44,869) and had lower net spending per beneficiary (median, $992 versus $32,287) compared with high added-benefit drugs.

“When negotiating prices for these drugs, Medicare should ensure they are not priced higher than reasonable therapeutic alternatives,” the authors write.

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