In the third quarter of 2017, PP&P polled a random, nationwide sampling of health system pharmacy directors on the factors impacting their generic purchasing decisions. We asked about budgeting practices, the impact of pricing changes, supply reliability, adding biosimilars to formulary, and future spending projections, among other topics. A total of 371 responses were received, yielding a confidence interval of 4.92 (95% +/- 4.92).
Survey results demonstrate a slow, but continual improvement in the availability of generics in bar coded unit dose. Unfortunately, the frequency of recalls also progressed slightly this year; nevertheless, most facilities continue to manage 10 or fewer recalls annually. Two other increases are more concerning: both drug shortages and the use of the gray market saw small, but significant upticks, following a few years of decline. The number of generic drugs involved in shortages also crept upward. These trends warrant continued watchfulness.
The issue eliciting perhaps the strongest response from pharmacy directors is unexpected spikes in drug pricing. This is a complex issue that continues to unfold. On one hand, most hospital pharmacies deemed this year’s generic drug budgets adequate. Furthermore, for the first year since we began tracking this data, a majority of facilities experienced average price increases with their generic purchases versus the significant price inflation that has marked this segment over the past few years. Certainly this year’s leveling off of price increases among many generic products is a welcome development. Nonetheless, given that generic drugs make up a progressively larger share of the hospital pharmacy’s drug budget, unexpected generic drug price spikes will continue to have an outsized impact on drug budgets.