|How Generic Lipitor will Process for Members|
Generic Lipitor (atorvastatin), expected to hit the U.S. drug market on November 30, 2011, will be a Tier 3 drug until the cost of Lipitor (brand or generic) is more competitive with the statin market overall. Wellmark also intends to leave the brand version of Lipitor on Tier 3 of the Wellmark Drug List at this time. For members with a two-tier drug plan, these drugs will be Tier 2 drugs.
This means that generic and brand Lipitor will process at the highest member cost-share expense.
Members who choose the brand-name medication will, in most cases, be responsible for both their Tier 3 cost share and the difference in cost between the brand and generic versions.
Generic competition for Lipitor is anticipated to increase significantly in July 2012 once the exclusivity arrangement has expired. At that time, Wellmark will reevaluate the formulary position (both brands and generics) to determine the most cost-effective tier placement of all cholesterol-lowering medications.
Wellmark, with its Pharmacy and Therapeutics Committee of independent practicing physicians, made these decisions after evaluating Lipitor for both efficacy and cost effectiveness, along with other available cholesterol-lowering medications (statins).
We encourage you to discuss generic alternatives with your patients and the use of generics as safe and effective choices over brand name medications.