Saving money is as easy as talking with your doctor

Copayments or coinsurance are generally much lower for generic medications, leaving more money in your pocket. In addition, many retail pharmacies offer generic medications for only $4.

The first step toward saving money is to discuss options with your physician, pharmacist or other health care provider. They can review your current prescriptions and recommend generics as appropriate.

“Helping patients save money is an increasingly important role for health care providers,” says Matt Hosford, Wellmark Blue Cross and Blue Shield pharmacy director. “And asking your doctor to prescribe generics is an easy way to do just that.”

Cholesterol-lowering medications —
a leading cause
of high drug costs

In 2010, Wellmark members in Iowa and South Dakota received nearly 750,000 prescriptions for cholesterol-lowering medications at a cost of more than $44 million.

The average cost of a brand name statin was $154, while the average cost of a generic alternative was less than $12.

Wellmark spent $19 million last year on Lipitor, the leading statin medication, at an average price of $152 per prescription (up 6.6 percent from 2009).

If everyone had received a generic cholesterol medication, more than $35 million could have been saved — a savings of 80 percent.

On average, a Wellmark member who is using a cholesterol lowering medication could save more than $600 annually by moving to a generic product.

Source: Wellmark Pharmacy Dept.,2011

So where would you fill up?

Two gas stations located in the same block. At one, the price for a gallon of gas is $12. At the other, it’s $150. In 2010, the average cost of a brand name statin was $154, while the average cost of a generic alternative was less than $12.

A prescription for savings

Paying even a nickel more for a gallon of gas seems foolish. We may even drive across town to find the cheapest price. Yet many of us don’t use the same shopping savvy with prescription drugs. In fact, millions of dollars are wasted among Wellmark members each year from choosing costly brand name drugs instead of inexpensive generic medications.

“Brand name prescription drugs are a leading driver of high health care costs,” says Matt Hosford, Wellmark Blue Cross and Blue Shield pharmacy director. “The good news is that, in many cases, generic medications exist at only a fraction of the cost of their brand name counterparts.”

“There are times when no generic alternative exists for a certain health condition. But for most of us, it comes down to this: If two drugs work the same, and are equally effective, would you rather pay $12 or $150?”

The 75-25 rule

While 75 percent of Wellmark members’ prescriptions are filled with generic medications, the remaining 25 percent make up 75 percent of the cost of all medications. And those costs add up — on average, about 15 cents of every premium dollar is used to pay for prescription drugs.

Hosford says many people consider their copayment — the amount they pay out of pocket for their prescription — as the actual cost of the drug. However, while the copayment may be $20, $30 or even $50, the actual cost of the drug is much higher. (NOTE: Out-of-pocket costs may be higher for people with coinsurance, who pay a percentage of the full price of their prescriptions.)

The truth about statins

If you have high cholesterol, you might be like 30 million other Americans who walk out of their doctor’s office with a prescription for a statin — a cholesterol-reducing drug such as Lipitor, Crestor or Zocor. Statins block a liver enzyme that helps create cholesterol.

Statins work wonders for many. The average person using a statin will see his or her “bad” cholesterol (LDL) drop between 20 and 60 percent in just one month.

Statins have become this country’s — and Wellmark members’ — most widely prescribed drug. Typically, the drugs achieve results with few side effects.

However, while these drugs are effective, they do not prevent heart attacks. “Many people believe that statins are a magic bullet — that a prescription for a statin will protect them from heart disease or a heart attack,” says Hosford.

Even if a statin lowers your “bad” cholesterol, heart disease can still develop. “Statins can help protect against a heart attack in an otherwise healthy individual,” says Hosford. “But no pill is a substitute for a healthy diet, getting regular exercise, losing weight, managing diabetes and quitting smoking.”

Want to learn more about your pharmacy benefits? Visit Wellmark.com and register for myWellmark for easy access to personalized pharmacy information.

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