Patient Out-of-Pocket Spending on Generic and Brand-Name Prescription Drugs - Summary - MDSpire
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Out-of-Pocket Costs for Patients Using Generic Versus Brand-Name Prescription Medications

  • By

  • Christopher L. Cai

  • Aaron S. Kesselheim

  • Benjamin N. Rome

  • September 11, 2026

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Objective:

To analyze the contributions of brand-name and generic drugs to out-of-pocket spending among US patients.

Approach:
  • Study Design: Cross-sectional analysis using the 2022 Medical Expenditure Panel Survey (MEPS) data.
  • Data Collection: Participants reported prescription medications used in the past year, confirmed by pharmacies.
  • Categorization: Medications were categorized as brand-name or generic using WHO classification codes.
  • Outcomes: Annual number of medications filled and out-of-pocket spending were analyzed.
Key Findings:
  • 51.91% of individuals filled generic medications, while 15.81% filled brand-name medications.
  • Mean annual out-of-pocket spending was $51 for generic drugs and $129 for brand-name drugs.
  • Nationally, estimated out-of-pocket spending was $16.8 billion for generic drugs and $13.7 billion for brand-name drugs.
  • Adults filled more medications and had higher out-of-pocket spending compared to children.
Limitations:
  • Findings are not generalizable to institutionalized populations.
  • The analysis did not include medications administered by clinicians.

Original Source(s)

Patient Out-of-Pocket Spending on Generic and Brand-Name Prescription Drugs

  • by Christopher L. Cai, Aaron S. Kesselheim, Benjamin N. Rome

  • September 11, 2026

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