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Generic Coupon Pilot Program a Winner for Insurer

Kate Traynor

An incentive program run by Blue Cross Blue Shield (BCBS) of Michigan has encouraged health plan members to try generic drug products—and to stick with them.

During the six-month pilot program, health plan members were sent a coupon that waived the initial copayment for the generic versions of certain prescription drugs.

According to a statement from BCBS Michigan, about 700 patients used the coupons, costing the health plan about $6,700 in waived copayment fees. But the increased use of generic products during the pilot program saved the health plan $190,000 in drug costs.

Glen Perry, director of Pharmacy Services Administration for the company, said the results of the pilot program indicate that "for a very little investment, you can get huge returns if you promote generic drugs appropriately to your membership."

Perry said the most surprising result of the pilot program was members' long-term preference for the generic drugs—nearly all of the members who used a coupon and refilled their prescription did so with the generic drug instead of the more-expensive brand-name product. The increased use of generic drugs during this time, he said, might have been affected by members' participation in two-tiered pharmacy benefit programs with reduced copayment fees for generics.

Perry added that educational efforts by BCBS may also have prompted the increased use of generic drugs.

"We spent a lot of energy trying to educate our members ...[about] the value of generics and the difference in cost of the drug," he said. "It may not be costing the member more in some cases, but at least they're aware that there is a difference in cost."

Perry added: "Whoever is paying the premium can make a connection that, if they're prudent in the way that they're purchasing their prescription drugs, [this] can result in keeping premium increases down in the future."

The coupon program was limited to 25 commonly prescribed drugs that were frequently filled with the brand-name product even though generic versions were available. Drugs that made the list included fluoxetine, enalapril maleate, nifedipine, and terazosin.

BCBS Michigan plans to expand the coupon program in January to include about 20,000 health plan members and, potentially, additional drugs. Perry said that the company is paying close attention to brand-name products for which cheaper generic versions may soon become available.

"We do have a whole clinical team here, including a drug information pharmacist, that is monitoring the patent life of certain blockbuster drugs," Perry said. "Prilosec is obviously one we're anticipating coming off patent that would provide a lot of opportunity for us," he added, referring to the popular proton-pump inhibitor by AstraZeneca.

Perry said that other drugs under consideration for the coupon program, if it is expanded, include generic versions of GlaxoSmithKline's Augmentin and Bristol-Myers Squibb's Pravachol.