Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"Add topic to email alerts Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . ” data-action=subscribe> Subscribe We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: If purchased through direct-to-consumer pharmacies, 80% of generic drugs with cost sharing of at least $15 would have lower out-of-pocket costs. Experts discussed the model\u2019s pros and cons. Direct-to-consumer pharmacies could offer substantial savings for patients taking generic medications, according to experts. John Lin, MD, MSHP, assistant professor of Health Services Research at The University of Texas MD Anderson Cancer Center, and colleagues recently published a research letter in Annals of Internal Medicine evaluating savings from direct-to-consumer (DTC) pharmacy models. Data derived from Lin JK, et al. Ann Intern Med. 2026;doi:10.7326\/ANNALS-25-05049. \u201cAs an oncologist, DTC pharmacies have helped many of my patients better afford their cancer drugs. It can be incredibly stressful to have a serious illness, like multiple sclerosis or cancer, and then not be able to afford your medicines,\u201d Lin said. \u201cWe wanted to make it easier for patients and prescribers to know when they should turn to DTC pharmacies for help.\u201d What are DTC pharmacies? DTC models offer transparent pricing and permit patients to purchase their medications without using their health insurance, in a bid to help patients afford generic prescriptions, Lin and colleagues wrote. However, some have questioned DTC\u2019s usefulness for those who are commercially insured, especially during cost-sharing, when patients must pay only part of the drug\u2019s cost after meeting a deductible. \u201cCommercial insurance relies on third parties to negotiate benefits packages and prices. You have to pay them to do that. They get involved with both generics and name-brand drugs, and I think over the years, they have shown themselves to be inefficient and expensive, which led to the creation of this DTC … that is run directly by the company, no middleman,\u201d Arthur L. Caplan, PhD, a professor and founding head of the division of medical ethics at NYU Grossman School of Medicine, told Healio. Caplan said these pharmacies will list the medications they have \u2014 almost always generic options \u2014 with a base price. Usually, they will add a handling charge as well, \u201cbut that\u2019s it.\u201d \u201cSo, roughly speaking, DTC is cheaper and easier to use if you\u2019re taking generics than commercial pharmacy benefit management (PBM) programs,\u201d Caplan said. \u201cIf you\u2019re still taking name-brand drugs, I think the PBMs both have more of those available, and they compete fairly well, because the DTC model usually doesn\u2019t try to cover name brands.\u201d Lin added that \u201cDTC models cut out the middlemen that lower costs for the insurance company but don\u2019t always trickle down to the patient.\u201d \u201cPBMs made close to $10 billion as middlemen charging for their negotiation between drug manufacturers and pharmacies. I think that is wasteful. It has not brought down health care costs. It hasn\u2019t really given greater access. It hasn\u2019t even really cut back on copays,\u201d Caplan said. \u201cHaving a for-profit middleman commercial PBM insurer has just not worked. So, the DTC model just has a lot more going for it.\u201d However, if patients have not yet met their deductible, paying cash through a DTC pharmacy will not count, Lin said. So, he only recommends using these after a patient has met their prescription deductibles. \u201cIt\u2019s important that doctors get informed about this too, so they can recommend to their patients what is best when they prescribe,\u201d Caplan said. \u201cThey may not have time to do that during a doctor-patient encounter, but putting information in the waiting room, putting up some videos that help explain the difference, I think would be very worthwhile.\u201d Direct comparisons In the study, Lin and colleagues matched coinsurance or copayment accounts for generic prescription claims from Merative MarketScan encounters and commercial claims in 2024 with 2025 direct purchase prices through the DTC Mark Cuban Cost Plus Drug Company (MCCPDC) based on drug name, quantity, strength and formulation. They analyzed 60,200,969 claims. The researchers found that purchasing through the DTC pharmacy would have saved patients a median of $6 in about 15% of prescriptions, but savings increased for medications with higher cost sharing. For generic drugs that had cost sharing of at least $15, patients would have seen lower out-of-pocket costs for 80% of the prescriptions if they had been purchased through the DTC pharmacy. Additionally, when the researchers analyzed generics with cost sharing of at least $100, they found a stark disparity. Through insurance, median out-of-pocket costs were $140. But through the DTC pharmacy, median out-of-pocket costs were $25 \u2014 equating to 85% in median relative savings, or $119 in median absolute savings. \u201cWe anticipated there would be savings with direct-to-consumer pharmacies, but what was surprising was the consistency and depth of the savings,\u201d Lin said. \u201cFor the highest cost generic drugs, patients who were paying $145 for their copay would only pay $25 through Mark Cuban Cost Plus Drugs.\u201d Lin also noted some of the disease areas where patients commonly see large savings for medications purchased through a DTC pharmacy, including the median savings and interquartile range (IQR) for each: cardiology ($110; IQR = $87 to $160): prasugrel, rivaroxaban, ticagrelor and valsartan; endocrinology ($120; IQR = $114 to $122): levothyroxine sodium; gastroenterology ($129; IQR = $84 to $219): mesalamine and prucalopride; neurology ($133; IQR = $99 to $279): lamotrigine, lurasidone, teriflunomide and topiramate; oncology ($468; IQR = $123 to $1,905): abiraterone, capecitabine, dasatinib and imatinib; psychiatry ($136; IQR = $102 to $224): atomoxetine, bupropion, desvenlafaxine and venlafaxine; transplant ($100; IQR = $71 to $208): tacrolimus; and urology ($139; IQR = $114 to $213): sildenafil and tadalafil. \u201cPrimary care physicians are overburdened and are often unable to speak with all of their patients about prescription costs. We hope that the simplicity of our message can help physicians and patients better understand options available to<\/p>\n","protected":false},"author":1,"featured_media":2840,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2839","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/2839","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2839"}],"version-history":[{"count":0,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/2839\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/media\/2840"}],"wp:attachment":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2839"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2839"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2839"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}