Your Rx for Better Health

What should you know about using generic medications?

With today's increasing medication costs, more attention is being focused on ways to reduce cost while continuing to maintain the highest level of care. Part of any discussion about cost should include the use of generic medications. Often overlooked by prescribers for newer and aggressively marketed brand name medications, generics can offer a high quality, low-cost alternative for many conditions.

What are generics?

While all medications have a generic name, not all medications are available to be dispensed as a generic. Why? When the manufacturer of a product applies to the Food & Drug Administration (FDA) to produce a new medication, they are granted a patent protection period. This period of time allows the manufacturer an opportunity to recoup the investments they have made in research and development and return a profit to the manufacturer's investors.

Once the patent for a product has expired, generic manufacturers may apply to the FDA to begin manufacturing. This application process requires the generic manufacturer to demonstrate that their generic version is equivalent to the brand name medication.

Once the testing of a generic medication is reviewed by the FDA, an equivalency rating is established. FDA ratings for all generically available medications are published annually in the "Orange Book."

The highest rating a generic medication can receive is "A." While some medications have lower ratings, the majority of generically available medications are rated "A" or "AB."

If you have a question about the rating of a specific generic medication, ask your pharmacist.

Why are generics less expensive?

When a new generic medication is introduced to the market, its price is dependent upon the number of manufacturers that will be producing the product. The more manufacturers, the greater the competition and the lower the price becomes.

Once a generic product has three or more manufacturers, it is usually MAC'd (maximum allowable cost) by prescription benefit programs. Simply put, this means that there is a maximum reimbursement that will be paid for the medication. This procedure helps prevent fluctuations in cost between generic manufacturers.

Often a MAC'd generic medication is one-fifth the cost of its brand name equivalent.

If I have a prescription card, how does this help me save money?

Generic medications can save you money two different ways.

1. Many plans provide their members with a lower out- of-pocket expense for generic medications.
2. The average cost for a brand medication is around $65 while the average cost for a generic medication is roughly $13.50. Using generic medications helps to reduce the cost for your plan and can help to minimize annual increases in your rates for health coverage.

Isn't it up to my doctor and pharmacist to decide if I get a generic medication or not?

Yes, to some extent it is. But you can have a discussion with your doctor and pharmacist to let them know that you are interested in identifying generic medications that could be used to treat your medical needs. For example, there are many medications available to treat high blood pressure. Some are not available as a generic, but there are many generic medications that can be used to treat high blood pressure for less than $10 per month.

Areas where many good generic medications are available, but underutilized, include:

• High Blood Pressure
• Antibiotics
• Medications for pain and inflammation
• Oral contraceptives
• Dyspepsia (indigestion, heartburn, low-grade reflux)
• Diabetes (some medications)
• Sedative hypnotic (sleep aids)

Any discussion regarding generics should start with your physician or pharmacist and should be a joint decision.

If you are interested in reducing your cost and the cost for your plan, here is what you should do.

1. Make a list of all the medications that you are currently taking.
2. On your next visit, to see your physician, go over your list and ask if there are any generic medications that can be substituted.
3. Before your provider prescribes any new medications for you, ask if there is a generic medication that would be appropriate.
4. Let your pharmacist know that you would prefer to receive generic medications whenever possible.