Wednesday, December 14, 2011

A Generic Season

Recently received emails from both Anthem and Medical Mutual, announcing changes in how cholesterol-lowering meds will be handled going forward. Effective this month, the generic form of Lipitor is being made available to insureds of both carriers.

From Medical Mutual:

"Medical Mutual® and its Family of Companies support the use of generic drugs as an effective way to keep costs down for our members and plan sponsors. This position is important given recent news stories about United Healthcare, Coventry, Catalyst Rx and Medco Health Solutions, Inc. (Medco), our pharmacy benefit manager, promoting brand name Lipitor® instead of its much-anticipated generic."

What this seems to be saying is that at least a few other carriers (and MMO's own PBM) are still pushing the more expensive brand-name version, with its concomitant higher co-pays.

The email goes on to note that "atorvastatin" (the "first generic equivalent for Lipitor") is available now, and other manufacturers' versions should be available beginning next summer. Both of these developments would seem to be good news for consumers, since competition generally means lower prices.

Anthem's announcement would seem to echo this theme:

"As of 12/01/11, the generic drug atorvastatin has been added to the preferred brand tier and is being processed with a preferred brand copayment for Medicare MAPD and PDP plans."

But, this doesn't hold true for "regular" insureds:

"Effective immediately, Express Scripts* will continue to dispense Lipitor through the home delivery program. Members participating in the home delivery program will pay the same copayment as for the generic atorvastatin."

One would think that they'd be pushing the generic over the brand-name, but that doesn't seem to be the case here. Not sure what to make of that.
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