title: Healthcare costs associated with switching from brand to generic levothyroxine.
abstract: BACKGROUND
  Controversy exists over the true therapeutic equivalence of branded and generic levothyroxine-the drug of choice for treating hypothyroidism-so professional societies recommend against switching between different formulations of the drug and suggest that patients who do switch be monitored. Payers typically encourage switching to generic drugs because of lower drug acquisition costs.
  
  
  OBJECTIVE
  To evaluate the impact of switching levothyroxine formulations on actual healthcare costs.
  
  
  METHODS
  Patients with hypothyroidism and at least 6 months of branded levothyroxine therapy were identified from a large healthcare claims database. Patients who subsequently switched to another levothyroxine formulation and could be followed for 6 months postswitch were matched to demographically similar patients who were continuous users of branded levothyroxine. Pre- and postswitch healthcare costs for each group were compared.
  
  
  RESULTS
  The savings in prescription drug costs after switching from branded to generic levothyroxine are offset by increases in costs for other healthcare services, such that switching is actually associated with an increase, not a decrease, in total healthcare costs.
  
  
  CONCLUSIONS
  In the absence of cost-savings, there is no clear rationale for switching patients from brand to generic levothyroxine.
authors.affiliation: Clinical Associate Professor, Department of Pharmacy Practice and Science, College of Pharmacy, Tucson, AZ.
authors.forename: Michael
authors.initials: M
authors.lastname: Katz
authors.affiliation: Clinical Professor of Family Medicine, Department of Family and Preventive Medicine, University of California-San Diego, CA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Scherger
authors.affiliation: Chief Medical Officer, MedicalEdge Healthcare Group, Dallas, TX.
authors.forename: Scott
authors.initials: S
authors.lastname: Conard
authors.affiliation: Researcher at Thomson Reuters, Washington, DC.
authors.forename: Leslie
authors.initials: L
authors.lastname: Montejano
authors.affiliation: Director at Thomson Reuters, Washington, DC.
authors.forename: Stella
authors.initials: S
authors.lastname: Chang