Every 1 additional prescription per 100 that is filled with a generic Rx in the Rochester NY region yields $82 million in annual cost savings to the community: specifically, to employers, consumers and health plans.

The Blue Cross Blue Shield Association presented findings from a survey and featured best practices from member plans in a webinar,Generic Drugs Can Be Good for Your Health and Your Wallet.”

Blues Plans believe that implementing generic drug programs can help Americans access drugs at an affordable cost. In BCBSA’s health reform recommendations, Pathway to Covering America, there are 5 key points: four are focused on cost and quality, and the fifth addresses expanding coverage for all Americans. Promoting use of generic drugs is a component in this proposal to stretch the US health dollar and to ensure outcomes. “Generic drugs is part of that story,” said John Frick, Director, Pharmacy Initiatives, at BCBSA.

The story is about value: “smart ways to do more with less,” Frick explained. An aging population, incurring more chronic illness with age, coupled with chronic illness occurring at younger ages, means that more Americans are using more drugs to treat these illnesses. Many of these drugs are getting very, very expensive.

To encourage the use of generics, Blues plans are developing partnerships with payers, new benefit designs, creative approaches to member education, and the sharing of best practices. Since beginning to track generic fill rate (that is, the percent of total Rx’s filled as a generic) since 2005, that rate has risen steadily. The generic fill rates for BCBS of Montana and BCBS of Massachusetts exceeded 70% in 2008.

As a new wave of generics is expected from now to 2011, the Blues see continued opportunity for cost-savings in moving enrollees onto generic drugs.

The savings have been huge: some number between $2.5-$5 bn in 2008 for employers and enrollees, according to Frick.

Dr. Joel Owerbach of Excellus in Rochester, NY, talked about that plan’s “Generics are real” campaign. The objectives of this campaign were to fill the communication gap on generics between doctors and patients, enhance adherence to meds and get full value out of the therapy, and capitalize on expected brand patent expirations anticipated in the next two years.

Excellus learned through a survey of Rochester citizens that 35% of residents never asked their physicians whether there was a generic available for their condition; 55% of people never asked about the cost of a drug. This was seen as an opportunity for education.

For the community of Rochester, the potential savings yielded by generic substitution are big. Take Topamax, which went generic just this week. In Rochester, about 137,000 people take Topamax at a cost of $45 million a year. The cost of generic Topiramate is 1/10th of the cost of the brand. The savings comes from reducing the $300 a month per migraneur to $30, a total savings for Rochester health stakeholders of $35 mm.

In Rochester, Owerbach calculated that every 1 additional generic script per 100 branded Rx’s across 5 million people in the Rochester region saves $82 million to community. In addition, the lower cost of a drug has a greater chance among patients of of therapeutic persistence and therefore better outcomes.

Part of the Excellus campaign was seeding the health consumer/Rx mantra: “Ask your doctor/pharmacist/NP if a generic drug option is right for you.” The poster at the top of this blog post is one of the print campaign examples used in local media to promote the message that, “Brand names are generics in disguise.”

Health Populi’s Hot Points: The key to Excellus BCBS’s program was consumer/patient engagement: the PR campaign not only educated people in an entertaining way — it activated people to think and ask the question: “is a generic drug option is right for me?”

Diane Mohorter, Senior Manager with Benefits at Birds Eye Foods in Rochester, has worked closely with Excellus on health benefit design for many years. Mowbower points out that, between carrots and sticks, Birds Eye wants to go with “carrots” in a Nudge-type fashion. That’s certainly appropriate for this food producer, but it’s also very pragmatic for all employers to ponder smart health benefit design for the new health citizen in this difficult economy.

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