There is a new class of drugs that has arisen in the U.S. – zombie brands. A zombie brand is a brand drug that has lost its patents and market exclusivity, but somehow just keeps on selling. You can throw as many generics at it as you want, and it may be leaking rebate dollars from every orifice, but it just keeps lumbering along, sucking up as much utilization and cash as possible.

Copaxone (glatiramer acetate) – a medication used to treat certain types of multiple sclerosis (MS) – is a zombie brand. But it’s not just your normal run-of-the-mill zombie brand. Teva’s Copaxone – approved way back in 1996 – is the king of zombie brands, with more than $1.2 billion in 2018 Medicare Part D sales. That would be impressive for any brand. But it’s even more impressive if you consider that Copaxone’s first generic competitor, Sandoz’s Glatopa hit the market in 2015, followed by Mylan in 2017. Even with the added competition, these generics had no chance. Teva still captured 82% of overall 2018 glatiramer claim volume in Part D despite cheaper (identical) generic options.

But our latest report is not about the traditional arsenal of weapons used by brand manufacturers to stall a generic's entry. It's about a loophole created by the federal government within its massive Medicare Part D program that actually provides the economic incentive to both patients and plans to choose expensive specialty brand drugs over cheaper generics. We call it the Brand-Name Drug Superhighway, and in 2020, half of all Medicare Part D plans rode the Copaxone Superhighway, five years after its first generic alternative hit the market. Behold this cruel example of regulatory irony in all its glory:

We were fascinated by how such a pernicious unintended consequence could somehow get embedded in the core of our country's largest prescription coverage program. As more and more specialty drugs go generic in the coming years, this nasty little "feature" of Medicare Part D could undermine the development of a competitive generic marketplace for these expensive drugs, increasing drug costs for seniors. If Copaxone is the proverbial "canary in coal mine," we figured we better understand exactly how this all works.

So buckle your seat belts and fly with us into the Medicare Part D cost share abyss. You may want to grab a vomit bag just in case, as it's going to be a sickening ride.

To best tell this story, we not only needed to purchase a considerable amount of data from CMS, but also – for the first time – worked with an immensely talented free-lance artist, Janelle Anderson (@janelleoart on Instagram), to create a really slick infographic.

We want to extend our heartfelt gratitude to the Mark Cuban Foundation, whose generous donation is allowing us to both expand our data arsenal and venture beyond the written word into new, and hopefully more effective, ways (like the above infographic) to educate the public on drug pricing.

Lastly, you may have noticed that 46brooklyn has a new look! Big thanks to Ben Rivet at Journeyman Productions for the new thematic logo (which tells you all you need to know about what we do) and the site redesign.

Medicare Part D is giving rise to zombie brand-drugs