Background: In the United States (U.S.), large price increases for selected generic drugs have elicited public\noutrage. Recent legislative proposals aim to increase price transparency and identify outlier drug â??price spikes.â? It is\nunknown how many and what types of products would be highlighted by such efforts.\nMethods: IQVIA Health Incorporatedâ??s National Sales Perspectivesâ?¢ provided sales, use and price data for all generic\nprescription products (unique molecule-manufacturer-formulation combinations) sold in the U.S. We estimated\nannual prescription price levels and changes between 2013 and 2014. We identify drugs with annual prescription\nprice increases in excess of the medical consumer price index (CPI), and in excess of 15% or 20%, per legislative\nproposals. We reported annualized inflation-adjusted mean, standard deviation (SD), median, and 95th percentile\nprescription price increases and percentage of products exceeding the growth in the medical CPI. We fitted logistic\nregression models to identify characteristics of drugs associated with each category of price increase.\nResults: We analyzed data for 6,182 generic products. The mean inflation-adjusted price increase among all generic\nproducts was 38% (SD 1,053%), the median, 2%; the 95th percentile, 135%; and the mean price level, $29.69 (SD\n$378.44). Approximately half of all products experienced price increases in excess of the growth in the medical CPI;\n28% had price increases greater than 15% and 23% had price increases greater than 20%. Drugs exceeding outlier\nthresholds exhibited lower baseline price levels than the mean price level observed among all generic drugs. The\nmost consistent characteristic predicting whether a product would exceed â??price spikeâ? thresholds proposed in\nlegislation is the being supplied by only one manufacturer.\nConclusions: â??Price spikesâ? among generic drugs in 2014 were more common than newspaper stories and legislative\nhearings suggest. While the cross-sectional association between an indicator of being sold by only a single manufacturer\nand the probability of meeting specific price growth thresholds is suggestive of an economically intuitive causal story,\nfuture work should delve more deeply into whether decreases in generic competition explain the dramatic price\nincreases that have captured the publicâ??s attention in recent years.
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