When a drug patent runs out, the price is supposed to fall. That’s the deal Americans strike with drugmakers: years of exclusive sales in exchange for cheap copies later. For many medications, the deal works. Once generics arrive, competition usually pushes prices down, and your copay often follows. But the handoff doesn’t always happen on schedule. A brand-name company can stretch its exclusive window long after the original invention, and every extra year at a monopoly price shows up in your pharmacy bill and your Medicare premiums. That’s the problem at the center of a new report from the AARP Public Policy Institute (PPI). Brand-name companies commonly use multipronged strategies to slow generic entry, including launching modified versions of existing drugs, building patent thickets and raising prices, according to the report, No Easy Solutions, released Sept. 22. A new AARP report exposes how drugmakers delay cheaper generics. Images By Tang Ming Tung / Getty Images How brand drugmakers stall cheaper copies The report was written by Leigh Purvis of AARP PPI and Anna Kaltenboeck and Jennifer Chen of Verdant Research. It warns that the drug industry faces an unusually high number of upcoming patent expirations, which raises the incentive to delay. The report groups the tactics into a playbook. Here’s how each one works, in plain terms: Patent thickets: A company files many overlapping patents on one drug, so a generic maker has to wait out, or fight, every one of them. Modified versions: A company launches a tweaked product, such as a new formulation or device, and steers patients toward it before the original faces competition. Price increases: A company raises the list price during its exclusive years, which lifts revenue right up until generics arrive. None of these is illegal on its own. That’s why the report’s title stresses that there are no easy fixes. Symbicort shows the playbook in action AARP used AstraZeneca’s (AZN) Symbicort inhaler, a common treatment for asthma and chronic obstructive pulmonary disease (COPD), to show how the tactics stack up. The key findings, according to a summary published by the Campaign for Sustainable Rx Pricing, a coalition that pushes for lower drug prices: AstraZeneca built more than 90 patents around Symbicort, covering both the active ingredients and the inhaler device. The key U.S. patents expired in 2023, ending a 16-year monopoly period. Symbicort’s list price rose 158% from 2007 to 2023, more than three times the rate of inflation, with the retail price climbing from $1,965 to $4,583. About one million Medicare beneficiaries a year are affected by Symbicort’s prices. The newer inhaler Breztri Aerosphere entered the market in 2020 at a significantly higher price than Symbicort, and Medicare spending on it grew rapidly through 2023, the same summary said. Generic competition was approved before those patents ran out. The Food and Drug Administration approved Viatris’ (VTRS) Breyna as the first generic version of Symbicort in March 2022, a year before the key patents expired, according to a Viatris press release. Who pays when generics arrive late Here’s the math in your wallet. If a drug’s retail price climbs from about $2,000 to about $4,600 over 16 years, every person paying a percentage-based coinsurance pays more each year the monopoly lasts. In my analysis, the bigger hit lands where you don’t see it on a receipt. Rising drug costs feed into Medicare Part D premiums over time, and TheStreet has reported that some Part D and Medigap premiums are set to jump by as much as 50% for 2027. That’s why delays matter even if you never use an inhaler. When one blockbuster drug stays expensive for extra years, the whole pool of Medicare enrollees helps pay for it. AARP wants Congress to curb patent thickets AARP’s report urges policymakers to consider legislation that limits drugmakers’ ability to delay generic competition. The CSRxP summary points to two Senate bills in the 119th Congress: The ETHIC Act (S. 2276), which would limit brand companies to asserting one patent from a group of related patents when they sue would-be competitors. The REMEDY Act (S. 2620), which would remove incentives to keep filing additional patents. Drugmakers have long argued that patents protect the investment behind new medicines. That tension is why these fights tend to move slowly in Congress. Use open enrollment to cut your prescription costs You don’t have to wait for Washington. Medicare’s annual open enrollment runs from Oct. 15 through Dec. 7, and it’s the best time to check how your plan covers your medications next year. Look up each of your drugs in your plan’s 2027 formulary, and check whether a generic or lower-cost alternative is covered. Ask your pharmacist or doctor whether a generic version, such as Breyna for Symbicort, is a fit for you. Compare plans using Medicare’s Plan Finder tool, because a cheaper premium can still mean higher drug costs. I’d also keep a list of every medication you take and what you paid this year. That record makes it much easier to spot a price jump before it surprises you. Generic drugs are supposed to be your reward for waiting. Knowing how that wait gets stretched is the first step to getting your share of the savings. Related: AARP explains huge new Medicare change coming soon
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