Industry Payments and Branded Glatiramer Acetate Prescribing in the US Medicare Program

Generic formulations of glatiramer acetate have been available since 2015 yet remain underprescribed relative to the branded product. We sought to characterize the association between branded glatiramer prescribing in the Medicare program and financial payments from the manufacturer (Teva Pharmaceuticals).

Using publicly available Medicare Part D and Open Payments data from the Centers for Medicare and Medicaid Services, we evaluated overall utilization from 2012 to 2021 and compared the prevalence, frequency, and magnitude of financial payments made in 2019 to neurologists who prescribed branded and generic versions of glatiramer in 2020. A multivariable logistic regression model assessed the association between receiving payments from the manufacturer and branded glatiramer prescribing while adjusting for neurologist demographic and practice characteristics.

In 2021, 52% of glatiramer prescriptions were for a branded formulation. Of 2,886 neurologists who prescribed glatiramer in 2020, 1,323 (46%) only prescribed branded, 364 (22%) only prescribed generic, and 929 (32%) prescribed both branded and generic versions of glatiramer. Of branded glatiramer prescribers, 53% (702 of 1,323) received a payment from the manufacturer compared with 39% (247 of 634) of generic-only prescribers (p < 0.001). Neurologists who received more than $120 per year had significantly increased odds ($121 to $230 per year, adjusted odds ratio [AOR]1.47, 95% CI 1.03-2.10; >$230 per year, AOR 1.87, 95% CI 1.28-2.73) of prescribing branded glatiramer compared with neurologists who received no payments.

Although branded drugs often rapidly lose market share with generic competition, branded glatiramer prescribing may persist because of ongoing financial relationships between neurologists and the manufacturer.