Drug Price Variability Among Medicare PDP Plan – Part 2: Generics By Plan

Written by Dr. Thomas Barus

June 20, 2020

In Part 1 of our pricing series we reviewed the entire marketplace combined for Medicare Part D PDP plans and pharmacies.

In this article, we will be breaking down pricing by plan. Our goal is to review how pricing differs across pharmacies for each Medicare PDP plan.

By Plans

Pricing By Plan by Cost Bin Across Pharmacies:

[Click to enlarge any photo]

Do Plans Reimburse more or less for Preferred Networks?

Analyzing a straight unit per qty mean price per NDC per pharmacy among plans preferred or non-preferred networks, graphically we see the large difference that may exist between pharmacies within the plan’s preferred or non-preferred networks. This is insightful information, but it certainly is only part of the story, as this analysis does not weight the utilization for each drug product within the pharmacy. Few conclusions can be drawn from this information, however it provides direction on the variation among pharmacies within a plans network.



In part 2 of our pricing series, we reviewed the pricing variations that exist among Medicare PDP plans and their networks. If you analyze the data more closely, you will be able to see various strategies being used by these plans among various pharmacies, such as higher or lower reimbursements. We continue to analyze this data and will provide further insights in the future, but do not hesitate to reach out to us if you want more information and detail.

In part 3 of our series, we will be diving deeper into Pharmacy specific pricing variations among Plans. Part 3 Link

In case you missed it, link to Part 1.

If you are interested in further statistics or details, please contact [email protected]

The Full Data Pricing File is available here for purchase: Full Data Pricing File

Disclaimer: All images and data from this post must be referenced for use on any other site or for other purpose.


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