Prescription Drugs

As far as effectiveness of the prescription drug, there is not a significant difference between the brand name and the generic drug. If a prescription is available in generic form, the FDA requires that prescription to have the same active ingredients as the brand name drug.

As far as the cost goes, there is a HUGE difference. Brand name drugs cost between 80%-85% more than their generic counterparts. This means higher costs and co-pays for plan participants in UNI’s self insured program. Using brand name over generic also costs the entire plan more. Higher costs from brand name drugs can lead to higher premiums in future plan years, for all plan participants.

• The average paid per brand name prescription was $200 compared to $25 for a generic.
• Generic utilization was more than 5.5 points below the average for Wellmarks book of business (BoB).
• For every 1 percentage point increase in generic utilization, our plan saves $90,000 per year.

Since UNI’s generic utilization was 5.5 points below the Wellmark Book of Business, there is an opportunity to save $500,000 per year!

Every time you receive a prescription, ask your healthcare provider, if there is a generic equivalent available. Learn more with Matt Hosford, who leads Wellmark Pharmacy Services, and explains what a drug formulary is and how it can help save you money.

The U.S. is one of two countries in the world that allows pharmaceutical companies to publicly market their products (direct to users). The cost of marketing contributes to the increased cost in brand name drugs. Direct to user marketing increases the utilization of brand name drugs, when a generic alternative or over-the-counter version is available and may be just as effective.

Tools

• Blue Rx Complete Formulary Drug List
• WebMD Find a Drug

Resources

• Food & Drug Administration
• Drug Safety