List Price Reductions Among Brand-Name ICS-LABA Inhalers in 2024 Were Associated With Increased Generic Uptake

Following the American Rescue Plan Act’s removal of the Medicaid rebate cap in January 2024, brand-name ICS-LABA manufacturers reduced list prices by 21-50%, and generic ICS-LABA use immediately increased by 23%, driven by gains in commercial plans and Medicare. The authors conclude that list these price reductions likely limited brand-name manufacturers’ ability to offer large rebates to PBMs, disrupting financial incentives that had previously suppressed generic uptake.