San Mateo County Times

Four of California’s largest health plans this week will begin offering coupons for generic prescription drugs to members in a drive to reign in soaring drug costs and raise public awareness of cheaper alternatives.

Blue Cross of California, Blue Shield of California, Health Net of California and PacifiCare Health Systems will send physicians coupons good for up to $10 towards the co-payment for patients’ first generic prescription. The majority of members pay a $10 co-payment for prescriptions, so that means their first prescription will be free.

Called Generic Advantage, the program is the first of its kind in California and the largest such program in the nation. It will focus on generic drugs for the six most commonly prescribed ailments — arthritis, acid reflux, diabetes, depression, high blood pressure and high cholesterol.

“The purpose of Generic Advantage is to sensitize patients to the value and efficacy of generic drugs,” said Dr. Robert Seidman, vice president and chief pharmacy officer for Blue Cross of California.

The health plans — which cover 15 million Californians — also will mail the 15,000 participating physicians brochures on the value and safety of generics.

The generics included were chosen by two faculty members of the University of Southern California Schools of Pharmacy and Medicine, based on effectiveness and cost.

“Once generic versions become available and their marketing, advertising and sampling programs cease, their use typically falls below what may still be therapeutically appropriate,” said Dr. Glen L. Stimmel, who developed the drug list, in a statement.

In other words, the insurers are saying to patients: If you suffer from high cholesterol, ask your doctor about the generic Lovastatin, instead of the brand-names Lipitor or Mevacor.

Patients will get a chart comparing the brand name drug they are familiar with — such as Prozac and Zantac — with its generic equivalent. They even can agree to place a card in their medical chart that tells physicians they prefer generics.

Switching just a fraction of patients to low-cost generics can amount to huge savings for patients as well as the insurers. Patients typically have a smaller co-pay for generics than brand-name drugs, so switching to a generic can amount to hundreds of dollars a year in savings, health plan officials said.

Generics already account for 53 percent of Blue Cross of California’s overall prescription drug usage. But persuading just 2 percent more members to move to a generic would equal a cost savings of $12 million a year, Seidman said.

Officials from the four plans said this savings would help hold down member co-pays and premiums in the long run.

The initial campaign will cost the four health plans about $250,000. Two faculty members from the Haas School of Business at University of California, Berkeley will monitor and evaluate the program for its effectiveness.

Jamie Court of the advocacy group Foundation for Taxpayers and Consumer Rights, which has been critical of insurance company profits and spiraling health care costs, said the program doesn’t get to the heart of the problem.

“It’s the doctors — not the patients — who are being lobbied aggressively by pharmaceutical companies,” Court said. “I don’t see how this will help that.”

Seidman of Blue Cross of California said that by getting patients involved, physicians will be more open to generics.

“I believe as long as questions start being asked about generic drugs, doctors will prescribe them where appropriate,” Seidman said.
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Contact Rebecca Vesely at [email protected]