You’ve seen the long, saccharine ads about the latest brand
name drugs, where patients take walks along the beach, attend their
grandchildren’s sporting events, and learn to make pottery. Brand-name drugs demand
high-end advertising.
And now, innovations in the way medicines are branded are
affecting your company’s pharmacy benefit costs. Drug manufacturers are
creating “combination drugs,” which utilize combinations of generic drugs to
secure new patents. This allows holders to do three things:
- Keep their market share of the individual drugs within the combination drug
- Obtain a new patent or expand an existing patent
- Influence patients to ask for the combination therapy
When doctors prescribe more expensive combination drugs, it
means you’re paying more for your employees’ prescription benefit. Let’s look at a few examples of combination drugs that are
driving higher prices:
Treximet (migraine pain made up of generic sumatriptan and
naproxen sodium)
- Branded drug costs $780 for supply of 9 tablets
- Same generic supply would cost $257
Duexis (rheumatoid pain)
- Branded combination costs $2,061
- Same generic components cost $20
Duac (acne medication)
- Branded combination sells for $336
- Individual generic components cost $41
This New
York Times piece explores the strategies pharmaceutical companies are using
to encourage consumers to use combination drugs: marketing slogans like “one
copay for one pill,” encouraging use of mail-order specialty pharmacies, and
more. Patients like combination drugs,
but they don’t realize the affect its having on insurance costs.
So what can employers do? Here are a few steps you should
take:
- Ask for a Combination Drug List from your PBM that shows the pricing difference between the combination and its generic components
- Exclude combination drugs that aren’t shown to be clinically non-inferior to the generic options
- Ask your PBM to monitor and report on patent expiration to keep your eye out for new combinations or branded drugs
For more strategies you can use to control prescription
spending, read the Artemis white paper on Rx overspending.
