Stat News has an article on a DOD IG report on the White House pharmacy during the Trump Administration. Lots of things stood out to me but one that is relevant for a lot of insurance design is the brand to generic spread:
White House medical staff also regularly asked for brand name medications like Ambien and Provigil instead of the generics because “their patients prefer using the brand name drugs,” a practice that contradicted military policy. Those two drugs alone cost the government $144,520 over the period from 2017 to 2019, whereas the generics would have cost $2,064, according to the report.
72:1
WOW
That is an incredible pricing spread. It is more than I typically see but I don’t spend a lot of time thinking about pharmacy pricing (one of my co-authors spends most of her day thinking about this, so I will learn a lot from her!). This is why insurers have fairly complex and confusing formularies that strongly encourage people to use generic drugs if available with low to no co-pays or deductible exposure.