Brand vs Generic: The Billion-Dollar Gap

Generic drugs are bioequivalent to their brand-name counterparts but cost a fraction of the price. Every brand-name prescription where a generic exists represents potential waste — and the numbers add up fast.

The Overall Picture

In 2023, Medicare Part D spent $185.46B on brand-name drugs and $39.45B on generics. The overall brand rate across all prescribers is approximately 13.4%.

Specialties with Highest Brand Rates

Some specialties have legitimately high brand rates (oncology, for example, relies on patented biologics). But others raise questions:

Why It Matters

The FDA requires generics to demonstrate bioequivalence — same active ingredient, same dosage, same route of administration. Yet brand loyalty persists among some providers, driven by pharmaceutical marketing, patient demand, or clinical inertia.

Shifting just 10% of unnecessary brand prescriptions to generics could save Medicare hundreds of millions annually — money that could extend Part D's solvency or reduce patient copays.