News Release

Prices for generic heart failure drugs vary widely

American Heart Association Meeting Report -- Presentation: T2134 -- Session: QU.APS.P271

Peer-Reviewed Publication

American Heart Association

NEW ORLEANS, Nov. 15, 2016 -- Prices for generic drugs to treat heart failure can vary so widely that uninsured patients may not be able to afford them, according to preliminary research presented at the American Heart Association's Scientific Sessions 2016.

Researchers surveyed 175 pharmacies in the greater St. Louis area encompassing eastern Missouri and neighboring Illinois to assess how much they charged uninsured customers for three generic medicines used to treat the heart-pumping problem known as heart failure: digoxin, lisinopril and carvedilol.

Researchers found that the combined cash price for the three drugs for 30 days ranged from:

  • $20.19 to $256.77 for the low doses of the drugs, with a median price of $67.98; and

  • $12.00 to $397.58 for the high doses of the drugs, with a median price of $70.68.

  • Similar data were obtained for 90-day supplies.

"The idea for the study originated with one of our patients, a 25-year-old man with heart failure, who called the office and said he could not afford to fill a prescription for digoxin," said Paul J. Hauptman, M.D., study senior author and professor of medicine and a cardiologist specializing in the care of patients with heart failure at Saint Louis University School of Medicine in Missouri. "When I found out that a month's supply was going to cost him $100, I couldn't believe it. Like me, I think a lot of doctors assume that if you're writing a prescription for a generic drug that it will be affordable -- and that's not necessarily the case."

The study did not find a link between price and type of pharmacy, or median income associated with the zip code in which the pharmacy is located. Surprisingly, two major pharmacy chains did not have consistent pricing across their own stores.

Hauptman added that it is common for patients with heart failure to take five or six medicines to treat the condition, making it even more difficult for patients to get the lowest combined price of the drugs they need.

"It's not reasonable to expect patients who are sick and of limited financial means to call or visit half a dozen pharmacies to get the best price," he said. "What is more likely to happen is that patients visit a pharmacy and find out that the drug is too expensive, so they don't fill the prescription and therefore do not garner benefit from guideline-directed medical therapy."

Since a greater understanding of pricing practices at the retail pharmacy level is required, the researchers said their study should be replicated across other parts of the country and with different generic drugs to treat other medical conditions.

Hauptman said he would expect the results of such studies to be similar. "With heart failure, we have a chronic condition that affects millions of people and usually requires treatment with several drugs. Why would it be different for other conditions?"

The results of these analyses may have significant policy implications given the potential impact on costs borne by patients and adverse outcomes if generic medications are no longer affordable for vulnerable patients who are uninsured or underinsured.

Heart failure doesn't mean that your heart has stopped beating. It means that your heart isn't pumping blood as it should. The heart keeps working, but the body's need for blood and oxygen isn't being met.

According to the American Heart Association about 5.7 million Americans are living with heart failure today. In fact, it's one of the most common reasons people age 65 and older go into the hospital.


Co-authors are Zackary D. Goff, B.S.; Andrija Vidic, D.O.; John T Chibnall, Ph.D. and Barry Bleske, Pharm.D. Author disclosures are on the abstract.

Note: Scientific presentation time is 1:30 p.m. CT, Tuesday, Nov. 15 in Science and Technology Hall, Population Science Section.

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