While there is no direct governmental price
control for commercial prescription drug
sales in the US, some publicly funded
programmes, such as Medicaid and
TRICARE (Department of Veterans Affairs),
have statutorily mandated rebates and
discounts. These effectively serve as price
controls for such programmes. Other
challenges include continuing pressure
on pricing, and the availability and use of
prescription drugs for commercial and public
payers continues to increase. This is due to,
among other things, an increased focus on
generic alternatives. Increased generics use
is also due to rising patient co-insurance or
co-payments for branded pharmaceuticals
and budgetary policies of healthcare
systems and providers, including policies
about the use of ‘generics only’ formularies.
In 2015, 84.0% of prescriptions dispensed in
the US were generic compared with 83.4%
in 2014. While the adoption of a broad
national price-control scheme in the near
future is unlikely, increased focus on
pharmaceutical prices and their impact
on healthcare costs is likely to continue.