CBC Health News

Potential Generic Drug Savings

Feb 07, 2021

Photo of Covid-19 Test kit

 

Huge Potential Savings from Transitioning Members to Generic Drugs

Are you aware of this huge savings opportunity with this new generic drug?

 

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?

Picture of prescription drugs, a blood sugar tester and test strips

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!

Pushback

We understand that some pharmacy benefit managers might provide you with a typical response, “the rebate on the branded product is better so we’re staying with the Brand.” However, it’s important to understand the historical trend of this branded product.  Per the chart below the list price of Tecfidera has increased from $7,216 to $9,369/month over a 5-year period, and as a result, unless your rebate guarantee is larger than the absolute inflationary increase, you lose value.

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

Next Steps:

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.

Blog Tags:

Generic Drugs, Prescription Drugs, Costco, Prescription, Dexilant, Jublia, Tecfidera, Prescription Discount, Generic Medicine, Prescription Cost, Medical Prescription

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