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PBM Boosts Use of Generics

Kate Traynor

California-based Prescription Solutions has an innovative program that encourages physicians and patients to give generic drug products a try before using the brand-name versions.

Through the program, the pharmacy and medical management company provides physicians with samples of generic drug products and educational material to give to appropriate patients. After about two weeks of therapy with the sample, if the patient and physician are satisfied with the therapeutic results, the patient receives a prescription for the generic product to take to a pharmacy.

"It really is all part of the step-care approach," says Joyce C. Salas, Pharm.D., director of clinical consultant services for Prescription Solutions, whose clients include government and private-sector health plans.

For example, the company uses the guidelines developed by the Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure, says Salas. "Beta-blockers and diuretics are recommended as first-line therapy for uncomplicated hypertension." By making generic versions of these drugs available as samples, she says, her company encourages physicians to think about generic products and use them before brand-name products for appropriate patients.

Prescription Solutions personnel look at the medical literature and at evidence-based guidelines on the treatment of chronic conditions, such as diabetes mellitus and hypertension, to identify drugs appropriate for the sampling program. Salas emphasizes that the physician, not her company, decides whether use of a generic drug product would be in a patient's best interest.

The company's promotion of evidence-based guidelines has been well received by physicians, Salas says. And along with the decreased copayments that result from having a prescription filled with a generic rather than the brand-name product, she says, patients enjoy the time spent with their physicians, who explain the sampling program and the place that generics can have in drug therapy.

The sampling program also offers physicians samples of generic antimicrobial products and provides educational material about the appropriate use of these agents.

Salas says that the roughly 200 physicians at eight medical groups and independent practice associations who participated in the sampling program's pilot phase prescribed more generics and fewer second-line products than before the project. Wendy Tercero, M.Ph., product development manager at Prescription Solutions, says this change in prescribing translated into a savings of up to 23 cents per member per month for the therapeutic drug classes targeted by the program.

The generic sampling program does not focus solely on the bottom line, however. According to Salas, the generic product samples are clinically equivalent to the brand-name versions. "I think it’s an important message to send to the [health plan] members that we’re balancing that cost-quality equation—that it’s not just all about cost," she says.