Planning for Patent Expiry: What Patients and Healthcare Systems Need to Do Now

When a drug’s patent expires, it doesn’t just mean a cheaper version hits the shelf. It means a system-wide shift-one that can save billions, but only if patients and healthcare providers plan ahead. Right now, we’re in the middle of the biggest wave of patent expirations in history. Between 2025 and 2029, over $90 billion in brand-name drug sales in the U.S. alone will open up to generics and biosimilars. That’s not a distant future. That’s happening now. And if you’re on a chronic medication, you’re already feeling the ripple effects.

Why patent expiry isn’t just about price

Most people think patent expiry = instant discount. But it’s not that simple. A brand-name drug might cost $500 a month. After the patent expires, the first generic might come in at $100. Sounds great, right? But then a second generic enters at $75. Then a third at $60. And suddenly, your pharmacy switches your prescription without telling you. You might not even notice-until you start feeling off.

That’s because generics aren’t identical. They’re bioequivalent, meaning they deliver the same active ingredient at roughly the same rate and amount. But they can have different fillers, coatings, or release mechanisms. For some patients, that’s enough to cause side effects. A 2022 Kaiser Family Foundation survey found that 37% of people on long-term meds reported new symptoms after switching to a generic. Not because the drug didn’t work-but because their body reacted to something new in the pill.

And it’s not just about pills. Biologics-drugs made from living cells-are even trickier. These are used for conditions like rheumatoid arthritis, Crohn’s disease, and certain cancers. Their patents are expiring now too, but the generic versions? They’re called biosimilars. And they’re harder to make. So they’re slower to enter the market. And even when they do, only about 38% of patients switch to them within two years. Why? Because doctors are cautious. Pharmacies don’t always stock them. And insurance plans don’t always push them.

What healthcare systems are doing (and what they should be doing)

Hospitals and health plans aren’t sitting idle. The smart ones started planning two years ago. They set up LOE (Loss of Exclusivity) task forces. These teams include pharmacists, doctors, finance officers, and contract managers. Their job? Track every patent expiration on the horizon. There are over 1,400 patent expirations each year in the U.S. alone. Miss one, and you miss a chance to save millions.

Here’s what they do:

1. At 24 months out: Map out which drugs are expiring. Check for secondary patents-because drugmakers often file dozens of them to delay generics.
2. At 18 months: Analyze the pipeline. How many generics are coming? Are any biosimilars approved? What’s the expected price drop?
3. At 12 months: Decide which drug to switch to. Is it the cheapest? The most reliable? The one with the fewest reported side effects?
4. At 9 months: Update clinical guidelines. Train staff. Make sure doctors know what to prescribe.
5. At 6 months: Send letters to patients. Explain the change. Offer support. Answer questions.

Systems that follow this timeline save 22% more than those that wait. One health system in the Midwest saved $4.7 million on a single heart medication by switching to a generic six months early. Another saved $12 million across three drugs by locking in contracts before prices dropped.

But not everyone can do this. Smaller clinics, rural hospitals, and independent pharmacies often don’t have the staff or software to track 1,400 expirations. That’s where tools like Symphony Health’s PatentSight come in. Used by 65% of top health systems, these platforms flag expirations, predict price drops, and even suggest alternatives.

What patients need to know

If you’re taking a drug that’s about to lose its patent, here’s what you need to do:

• Know your drug. Is it a small molecule (like atorvastatin or metformin) or a biologic (like adalimumab or rituximab)? Small molecules have faster, cheaper generic switches. Biologics take longer and cost more.
• Ask your pharmacist. When your prescription is refilled, ask: “Is this the same as before?” If the pill looks different, or the name changed, ask why.
• Don’t assume cheaper is better. If you feel worse after a switch, tell your doctor. It’s not “all in your head.” It might be a filler, a coating, or a different release time.
• Check your insurance. Some plans push certain generics. Others don’t cover biosimilars at all. Ask: “Will my copay change?” and “Is there a preferred generic?”
• Don’t stop taking your med. If you’re told you’ll be switched, don’t skip doses. Work with your provider to make the change safely.

Medicare Part D beneficiaries had a rough time in 2022. Forty-two percent were switched to a different drug without warning. Twenty-eight percent were confused about why. That’s preventable. Patients deserve clear, timely communication.

The hidden traps

Drug companies don’t just wait for patents to expire. They fight it. Here’s how:

• Patent thickets. One drug might have 50+ patents-not just on the active ingredient, but on the shape of the pill, the time it releases, the color of the coating. These aren’t real innovations. They’re legal barriers.
• Pay-for-delay. Sometimes, the brand-name maker pays a generic company to stay off the market. The FTC says this cost Americans $13 billion in 2023 alone.
• Product hopping. A company releases a slightly modified version-say, a new extended-release pill-and tells doctors to switch patients. Then they patent that new version. It’s not innovation. It’s a delay tactic.

The 2023 CREATES Act cracked down on some of these tricks. And the FDA is speeding up approvals for complex generics. But they’re still happening. And they’re still costing patients money.

What’s coming next

By 2028, biosimilars could save the U.S. $150 billion. But only if we get past the slow adoption. Right now, only 27% of biologic prescriptions are filled with biosimilars. Compare that to 90%+ for small-molecule generics. Why the gap? Because biosimilars are harder to make. They’re more expensive to develop. And doctors still don’t trust them fully.

But change is coming. The Inflation Reduction Act lets Medicare negotiate prices for drugs after patent expiry-starting in 2026. That will force manufacturers to lower prices faster. The FDA’s new rules are cutting approval times for complex generics from 18 months to 12. And AI tools are now predicting patent expirations with 89% accuracy-up from 65% just two years ago.

The future isn’t just cheaper drugs. It’s smarter systems. Systems that track expirations, educate patients, and negotiate contracts before the price drops-not after.

What you can do today

You don’t need to be a hospital administrator to act. Here’s your checklist:

1. Look up your current medication. Search “[Drug Name] patent expiry 2026” online. You’ll find databases like Drugs.com or the FDA’s Orange Book.
2. Call your pharmacy. Ask if your drug has a generic. Ask if a biosimilar is available. Ask if your insurance prefers one.
3. Talk to your doctor. Say: “I heard this drug might lose its patent soon. What does that mean for me?”
4. Keep a log. Note how you feel before and after any switch. Write down side effects. Bring it to your next appointment.
5. Advocate. If your plan won’t cover a cheaper option, ask why. File a complaint with your state insurance commissioner if needed.

Patent expiry isn’t a problem to be solved. It’s an opportunity to reset. To save money. To improve access. To make healthcare fairer. But only if we act-before the switch happens.