Rx Abandonment Rate Continues to Rise

The number of prescriptions filled in the retail sector was up 2.7 percent in 2009 from single digit growth in 2008. That’s the good news. The not-so-good news is that the number of scrips being filled for generics is beating branded drugs 2 to 1, and the rate at which drugs are being abandoned at the pharmacy continues to climb.

According to data from Wolters Kluwer Pharma Solutions, 2.6 billion generic prescriptions were filled last year, versus 1.3 billion branded scrips-and the rift between the two is growing. Consider that in 2005, branded and generic scrips were filled at the same rate-1.6 billion.

Looking at volume increase of commonly prescribed therapeutic classes of medications, big gains were made in cholesterol reducers (up 5.7 percent) and anti-ulcerants (up 5.2 percent). Diving deeper to specific branded drugs, Lipitor has seen its number of prescriptions drop nearly 12 percent since 2008. But it’s competitor, Crestor, has spiked year-over-year by close to 25 percent.

“One of the things contributing to the increase in Crestor [prescriptions] is that we’ve seen AstraZeneca do a better job in terms of formulary access-access for patients to get the product on a less-restricted formulary or a lower copayment,” said Dea Belazi, consulting practice leader, Wolters Kluwer Pharma Solutions. “There have also been more recent studies published for Crestor, with potential outcomes benefits that have allowed physicians to feel more comfortable prescribing it.”

On the other end of the spectrum, Lipitor has suffered negative impact based on managed-care formularies. “They are adding step therapies or step edits. In other words, trying a generic first before getting branded Lipitor,” Belazi said. “We are also seeing more Lipitor scrips at a higher copayment then we have in the past.”

It will be interesting see how the data change for times during which the unemployment rate continued to increase. According to the report, the number of prescriptions being abandoned at the pharmacy is rising-a sign that the economy isn’t exactly improving.

“Abandonment” refers to a pharmacy submitting a transaction to a payer and the payer approving the prescription, but the customer-for some reason-never picks up the purchase. This is different from “denial,” which is when the payer rejects payment for the prescription.

The abandonment rate-particularly for new prescriptions-has seen a significant increase from 5.09 percent in 2008 to 6.33 percent in 2009. Abandonment of refills has seen a much smaller increase, from 2.41 percent the previous year to 2.56 percent. Moreover, the total abandonment rate since 2006 has jumped close to 68 percent, with generics being abandoned at the same rate as branded drugs were abandoned in 2007.

“If we’ve already seen the worst of the worst, then why are prescription being abandoned at a greater rate than they were six months ago?” Belazi wondered.

That question might not be answered for another year.