Prescription drugs are a significant part of the cost of healthcare, especially when considering that up to 45 percent of people in the country used at least one prescription drug in the last 30 days (according to the National Center for Health Statistics / National Health and Nutrition Examination Survey, 2015-2016,
https://www.cdc.gov/nchs/products/databriefs/db334.htm).
Generic drugs are equivalent to their brand-named counterparts, typically cost less and are available for most health conditions. So how can employers and employees take advantage of generic drugs to save money on their healthcare plans?
As you know, there is a growing list of low-value products which should be removed from every commercial plan formulary. Those exclusions include popularly promoted products like Jublia, Luzu, Auvi-Q, etc. Each and every one of these products has a lower cost and more effective clinical generic or biosimilar alternative available in the marketplace for your employees and their physicians to use.
However, let’s consider a new material opportunity with a recently introduced generic for the drug Tecfidera.
Tecfidera is a commonly prescribed specialty medication to treat relapsing forms of Multiple Sclerosis. (MS). Based on your employee population it is likely your pharmacy plan also has significant utilization of this medication.
A generic alternative became available October 1, 2020. If you were to migrate your employees who use the branded Tecfidera to the more affordable generic (Dimethyl Fumarate), the savings is approximately $3,500 per utilizing month, or $42,000 in savings per patient annually.
For a large employer with 3,000 employees, the potential annual savings is $3 million!
Package Price | Effective |
$9,931.07 | 1/1/2020 |
$9,368.94 | 1/1/2019 |
$8,838.66 | 1/1/2018 |
$8,184.00 | 1/1/2017 |
$7,578.00 | 1/1/2016 |
$7,216.80 | 1/1/2015 |
Has your pharmacy benefit manager made you aware of this savings opportunity?
If you haven’t had the discussion, we recommend you contact your pharmacy benefit manager today and inquire about the potential savings available to your plan.
If you need help, please don’t hesitate to reach out to CBC for assistance. We’ve found that the key to successful management of all high-cost drugs and providing quality care to our clients’ employees requires a consistent and proactive approach to new drugs entering the market and ongoing diligence from your selected vendor.
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