Savings expected from shift to generic cholesterol drugs

Updated 10:45 AM January 4, 2007

Savings expected from shift to generic cholesterol drugs

By Wendy Frisch
Human Resources Communication

Physicians and their patients enrolled in the U-M Prescription Drug Plan who take brand-name, cholesterol-lowering statin medications, such as Zocor, Crestor, Pravachol and Lipitor, will be encouraged to shift to lower-cost generic prescriptions beginning Jan. 1.

Statins are a widely prescribed class of drugs that lower the amount of cholesterol and certain fats in the blood by inhibiting a key enzyme that helps make cholesterol. The generics—lovastatin, pravastatin and simvastatin—are low- to medium-potency statins that provide adequate cholesterol reduction in most patients. These generics were introduced to the market in recent months as patents for Pravachol and Zocor expired in April and June.

The Benefits Office estimates that 8,000 of the 80,000 members of the Prescription Drug Plan take some form of statin medication to help reduce cholesterol, at a combined cost to the University and its employees of over $6 million a year. Unlike medications like antibiotics, typically taken for short-term treatment, the majority of patients who take statins continue their drug therapy for the rest of their lives, resulting in significant long-term treatment costs for the University and the employee.

Of the drug plan participants on statins, 62 percent, or about 5,000, take the name brand Lipitor, which along with Vytorin will move to a Tier 3 or nonpreferred drug classification, requiring a $24 co-pay beginning Jan. 1. Lipitor is available in 10-, 20-, 40-, and 80-milligram dosages. (Lipitor 80 milligram will continue to be a preferred or Tier 2 product for patients whose condition requires greater reductions in cholesterol.)

Lipitor costs the University approximately $3.46 per tablet, which translates into $1,263 per patient per year on average. By contrast, the average cost for an FDA-approved generic statin product is 70 cents per tablet, or approximately $256 per year.

The plan member co-pay cost for a one-month supply of 10-, 20- or 40-milligram Lipitor is $24. The co-pay for a one-month supply of generic statins is $7, and this cost can be reduced to as little as $3.50 for a 30-day supply for those who participate in the University's pill-splitting program, in which co-pays for employees and other covered plan members are cut by 50 percent. Plan members also can save by ordering 90-day generic supplies for $14 (two co-pays) through Walgreens Mail Service, the Prescription Drug Plan mail-order pharmacy supplier.

Keith Bruhnsen, manager of the Prescription Drug Plan, estimates that every
1 percent of Tier 2 (preferred) or Tier 3 (nonpreferred) brand-name drug prescriptions converted to generic or Tier 1 alternatives, results in a University savings of more than $500,000.

"Generic statins are chemically identical to their brand-name counterparts, contain the same active ingredients, and are tested to assure they achieve similar levels of drug concentration in the body," Bruhnsen says. "The U-M Prescription Drug Plan has worked hard to reinforce the merits of generic medications.

"The movement to generic drugs saves a significant amount of money for plan members and for the University. Generic dispensing is currently at 59 percent of all medications and is expected to grow even more over time.

"Increased utilization of generic medications can help us to stem the rate of increase in health care costs, as well as reduce the amount of co-pay expenses paid by our employees, which have remained significantly lower than national averages for the past several years."

Experts in the Benefits Office, M-CARE pharmacy and medical staff and the U-M Health System (UMHS) Department of Pharmacy reviewed the medical evidence on generic statin drugs before recommending them as a preferred product for most patients.

"The evidence indicates that generic statins are safe and effective and, for the majority of patients, achieve the same level of reduction in LDL cholesterol," says James Stevenson, associate dean and clinical professor in the School of Pharmacy.

Drug plan members who currently have brand-name statin drug prescriptions on file with their pharmacy will receive a letter this month from SXC Health Solutions, the U-M drug plan administrator, informing them of the change. Physicians within UMHS also will be contacted as part of an initial outreach effort, asking for their cooperation and permission to change covered patient statin prescriptions from brand name to generic medications.

The Benefits Office recommends that drug plan members who currently take name-brand statin medications consult their doctors at the next office visits to see if their prescriptions can be changed to one of the generics. To take advantage of least-cost pricing, the Benefits Office also encourages patients taking statin medications to ask their doctors about pill splitting.

All three generic products are part of a voluntary pill-splitting program that provides an additional opportunity to save on co-pays. The program that took effect Jan. 1 of this year allows U-M faculty, staff and retirees to cut their prescription co-pays in half by splitting the medications they take to reduce cholesterol.

Drug companies charge the same amount for a 30-day supply of drugs whether the dosage is 20, 40 or 80 milligrams, so by pill splitting the University and the patient can save money. The University provides a pill splitter for program participants.

For more information on the pill-splitting program go to www.umich.edu/~benefits/forms/Pill-Splitting-Instructions.pdf.

Savings expected from shift to generic cholesterol drugs

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