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Estimating Costs of Market Exclusivity Extensions For 4 Top-Selling Prescription Drugs in the US

2025· article· en· W4413418246 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueJAMA Health Forum · 2025
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicPharmaceutical Economics and Policy
Canadian institutionsUniversity of Calgary
Fundersnot available
KeywordsMedicare Part DCompetition (biology)Prescription drugGeneric drugBiosimilarMarket shareManaged careBusinessDrug pricesActuarial scienceMedical prescriptionOrphan drugMarketingHealth careMedicineEconomicsPublic economicsDrugPharmacology

Abstract

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Importance: Brand-name drugs in the US are sold at high prices during market exclusivity periods defined by their patents, before prices are lowered by generic competition. Drug manufacturers use several strategies to extend these market exclusivity periods and delay generic competition, including obtaining overlapping thickets of patents. Objective: To estimate excess US spending associated with delays in generic competition due to extended market exclusivity for 4 top-selling drugs. Design, Setting, and Participants: This retrospective serial cross-sectional study focused on 4 top-selling drugs that experienced new generic competition between 2014 and 2018 to allow enough time for determining postexclusivity price trajectories: imatinib (Gleevec, cancer), glatiramer (Copaxone, multiple sclerosis), celecoxib (Celebrex, arthritis), and bimatoprost (Lumigan, glaucoma). Drug monthly spending data from 2011 to 2021 were retrieved from a large commercial claims database (Merative MarketScan) and a random sample of Medicare beneficiaries with at least 1 month of Medicare Parts A, B, and D coverage and adjusted for estimated rebates obtained from SSR Health, LLC. The analysis was performed between March 2023 and January 2024. Exposures: Extended market exclusivity was calculated as the time between expiration of the key patent and first generic marketing. Main Outcomes and Measures: The primary outcome was net monthly national drug spending in commercial insurance and Medicare Part D. Spending was estimated under 2 scenarios: (1) the status quo, reflecting observed spending trends, and (2) a counterfactual scenario, modeling spending in the absence of extended market exclusivity. Segmented linear regression analyses were used to assess level and slope changes in monthly spending following generic entry. Weights were applied to extrapolate sample-based estimates to the full US commercially insured and Medicare Part D populations. Results: Market exclusivity extensions beyond expiration of the key patent ranged from 7 (celecoxib) to 13 (glatiramer) months. In the absence of extended market exclusivity, and over a 2-year period following generic competition, net spending would have decreased by $3.5 billion, including $1.9 (95% CI, $1.3-$2.5) billion in commercial plans and $1.6 (95% CI, $1.1-$2.1) billion in Medicare-including $67 (95% CI, $22-$115) million for bimatoprost, $726 (95% CI, $516-$938) million for celecoxib, $1.7 (95% CI, $1.0-$2.4) billion for glatiramer, and $1.0 (95% CI, $0.8-$1.2) billion for imatinib. Conclusions and Relevance: This study found that promoting timely generic availability and avoiding extending market exclusivity for top-selling drugs may result in substantial savings for US patients and payers, including both public and private health insurance programs.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Theoretical or conceptual · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.725
Threshold uncertainty score0.392

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.046
GPT teacher head0.342
Teacher spread0.295 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it