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September 22, 2018

Health Care: You can bend the cost curve


By Joel Owerbach, Pharm.D., vice president and Chief Pharmacy Officer for Excellus BlueCross BlueShield

The buying decisions you make with over-the-counter and prescription drugs can have a dramatic impact on your household budget.

For over-the-counter drugs, choosing store brands instead of name brands can represent a substantial savings to you without sacrificing quality. Ask the pharmacist for help in making a selection.

For medications that require a prescription, ask your doctor if a generic equivalent or alternative would work for you. Generics typically have the lowest health insurance copay. If you don’t have prescription drug coverage, the out-of-pocket savings with generics can be huge.

According to pharmacy industry sources, 14 popular brand-name drugs are planned to become available in generic form for the first time this year. They include Cozaar and Hyzaar to treat high blood pressure, Effexor XR to treat depression, Aricept to treat Alzheimer’s disease and Flomax to treat enlarged prostate.

With just these 14 new generics, upstate New Yorkers could reduce health care spending by more than $100 million this year.

To illustrate the possible savings: Nearly 40,000 men in upstate New York use Flomax at an annual expense of $53 million. The retail price for brand-name Flomax is about $140 for a 30-day supply, while the generic version will eventually be about $75. For individuals with prescription drug coverage, brand-name Flomax has one of the higher-level copays (anywhere from $30 to $100 per month), while the generic version will have the lowest-level copay (typically $10 or less per month).

Most drug manufacturers are granted an exclusive patent to produce a brand-name drug for a fixed period of time. Once the patent expires, other companies can produce a generic version and sell it at a lower price. As more manufacturers begin production, the price of the generic drops further. Ultimately, a generic could cost 50 percent, 75 percent and even 90 percent less than the brand-name version.

In 2011, another 14 highly advertised drugs are expected to become available in generic form. They include Yaz for birth control, Actos for diabetes and the popular high cholesterol drug, Lipitor. About 140,000 upstate New Yorkers currently use Lipitor to treat high cholesterol at an annual expense of more than $174 million.

More and more upstate New Yorkers are making the switch to generics and cutting their health care spending. Since 2005, measurable increases in the use of generic drugs as alternatives to higher-priced brand-name drugs have resulted in savings of nearly $1 billion, according to analyses by Excellus BlueCross BlueShield.

The take away from all of this is that you have the power to immediately bend the health care cost curve. Check with your pharmacist and your doctor. By switching to store brands and generics whenever possible, you can start reducing your health care spending today.

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