Wellmark Blue Cross Blue Shield offers Cost Savings for Members Who Try Generic Statins.
DES MOINES, IA - Wellmark Blue Cross and Blue Shield is providing some financial savings to its members who start taking generic statins to lower their cholesterol.
Members will receive their first one month supply of a generic statin without having to pay anything at the pharmacy as part of a new generic statin waiver program that the company introduced on January 1. The program applies to members who have not filled a generic statin prescription in 2008 or 2009.
"Many of our members are facing tough times with the recession," says Wayne Knisley, PharmD, Wellmark's pharmacy director. "To encourage our members to try generic statins - which have lower out-of-pocket costs than brand-name statins - we're introducing a program that allows members who have not tried a generic statin to get their first one month supply at no cost. The member saves money on their initial fill by having their cost share waived, and, if they remain on the generic, they'll have lower out-of-pocket costs every month compared to a brand-name statin."
The generic statin copay waiver program is available to the more than 1 million Wellmark Blue RxSM Preferred and Blue Rx drug card individual and insured group members (once they meet their annual prescription deductible, if applicable, unless the plan waives deductibles for generics). Members of self-funded employer groups are eligible only if their employer group has pharmacy benefits through Wellmark and has chosen to participate in the program.
The yearly out-of-pocket savings for an individual who chooses to move to a generic statin from a brand-name statin could be substantial. The average generic copayment for a 30-day supply is $10 or $120 a year. The average copayment for a 30-day supply of Lipitor, a commonly prescribed brand statin, is $50 or $600 a year.
"In addition to receiving their first 30-day fill at no cost, the average member is going to save nearly $500 a year in out-of-pocket costs by choosing a generic statin over a brand-name," says Knisley. "And since many of the $4 generic programs offered by local pharmacies also include generic statins, members can save even more money by asking their doctors for generics. Generics are one of the easiest ways for consumers to save money at the pharmacy without compromising quality."
There are three generic statins that qualify for the waiver program: simvastatin (generic Zocor); lovastatin (generic Mevacor); and pravastatin (generic Pravachol).
Paul Karazija, M.D., Wellmark's interim Chief Medical Officer, says numerous studies have shown that clinically, generic statins are an appropriate option for most patients.
"Most patients, unless they need a very large reduction in cholesterol or have had a major coronary event such as a heart attack, can receive adequate reduction in their cholesterol levels through the various strengths available in the generic options," Dr. Karazija says. "If you're currently taking a brand-name statin, simply ask your doctor if a generic option will work for you. Doctors don't usually know the out-of-pocket prescription costs for their patients, so if you let them know the savings you can achieve by taking a generic, most will be willing to write you a new prescription. This is where good communication with your doctor can truly pay off."
Members who are currently taking a brand-name statin most likely will need a new prescription to move to a generic statin. Lipitor, for example, does not have a generic available and is not expected to be available as a generic until the fall of 2011. But since generic options are available from the same chemical family as Lipitor, doctors can write a new prescription for a generic alternative such as simvastatin.
"Anytime you take a prescription medication, ask your doctor or pharmacist if a generic option is available and appropriate for your medical situation," Knisley says. "In most drug classes, there is at least one generic option available. The savings can be significant - especially if you are taking a maintenance medication such as a statin. From a clinical standpoint, a generic statin is appropriate for most people unless they require an extremely high dosage for significant cholesterol reduction. In those situations, a generic statin may not be the right choice. Simply talk to your doctor about what options are available."
In the past year, Wellmark's generic utilization for its drug card members has increased nearly six percent to more than 66 percent. The generic statin copay waiver program is effective through June 30, 2009.
In the future, Knisley said that Wellmark may consider including other drug classes in the copay waiver program.
Wellmark, Inc. (www.wellmark.com ) does business as Wellmark Blue Cross and Blue Shield of Iowa. Wellmark and its subsidiaries and affiliated companies, including Wellmark Blue Cross and Blue Shield of South Dakota and Wellmark Health Plan of Iowa, Inc., insure or pay health benefit claims for more than two million members in Iowa and South Dakota. Wellmark Blue Cross and Blue Shield of Iowa, Wellmark Blue Cross and Blue Shield of South Dakota, and Wellmark Health Plan of Iowa, Inc. are independent licensees of the Blue Cross and Blue Shield Association.
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