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Estimating Savings Opportunities From Therapeutic Substitutions of High-Cost Generic Medications

In this cross-sectional analysis of the top 1000 generics in Colorado’s all-payer claims database in 2019, 45 high-cost generics that had lower-cost therapeutic alternatives of same clinical value were identified. Overall, high-cost generics were 15.6 times more expensive than their therapeutic alternatives (median values); if the lower-cost alternatives had been used, total spending would have been reduced by 88.3%.
Publication

Customized Care for Complex Conditions in Medicare Advantage

Medicare beneficiaries frequently select suboptimal Medicare Advantage plan products or elect traditional fee-for-service Medicare due to choice paralysis, cognitive impairments, and consumer health insurance illiteracy. Medicare Advantage Chronic Condition Special Needs Plans (C-SNPs) offer an opportunity to tie disease to both plan design and marketing, simplifying consumer choice architecture.