Abstract
Evergreening consists of multiple ways that pharmaceutical companies extend patent protection and prolong profitability of brand name drugs past patent expiration. In psychotropic medications, these strategies do not necessarily make more effective drugs, and often increase drug prices, which can result in lower access and utilization. There has not been a systematic literature review of evergreening strategies for psychiatric medications. Based on such a review, 11 strategies were identified and relevant examples were provided. Four case examples of commonly used psychiatric medications indicated evergreen prices 3 to 211 times the cost of the original medication, and the evergreen costs ranging from $132.00 to $10,125.24 higher than the original cost on an annual basis. The higher cost of evergreening medications can create inefficiencies and waste in healthcare resulting in lower-quality patient care. Healthcare providers, patient advocates, health insurance companies, and policy-makers should be aware of these practices to improve healthcare systems.
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This article was supported by the Department of Psychiatry, University of Hawai‘i at Mānoa. The contents of this article are solely the responsibility of the authors. The authors would like to express their appreciation to the staff of the Department of Psychiatry.
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The authors declare no conflict of interest. The authors report no external funding source for this study. This article was partially based on the following presentation: Andrade, J. K. L., Fujimoto, C., Takeshita, J., & Hishinuma, E. S. (2019, September). Practice of evergreening on psychiatric medications and its impact to consumers and society. Poster presented at the annual meeting of the World Congress of the International College of Psychosomatic Medicine, Florence, Italy.
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Andrade, J.K.L., Fujimoto, C.J., Hishinuma, E.S. et al. Evergreening of Psychiatric Medications: A Systemic Literature Review of Strategies, Case Examples, and the Implications of Cost. Community Ment Health J 59, 451–458 (2023). https://doi.org/10.1007/s10597-022-01022-9
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DOI: https://doi.org/10.1007/s10597-022-01022-9