Tuesday, 19 Nov 2019

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When Cheap Generics Morph Into Expensive Prescriptions

The Wall Street Journal has reported an alarming trend in generic drug pricing that affects many, especially the elderly and those with arthrtis.

Pharmaceutical companies have developed a growing number of combined generic products whose sum is far more than the cost of the individual generics.  For example, the migraine medication Treximet has two active ingredients—sumatriptan and naproxen.  As generics these two drugs may result in a copay is zero dollars for the average patient.

A box of nine tablets of Treximet costs $728.67, according to Truven Health Analytics. But the average actual cost for a box is about $353, and the cost of its two constituents, sumatriptan and naproxen, would cost around $19, according to GoodRx.

Others combo agents in this category include acne cream Acanya, Duexis and Vimovo for arthritis pain and the weight-loss pill Qsymia.

For both Duexis (ibuprofen and famotidine) and Vimovo (napoxen and esomeprazole), the generic drugs individually would cost $20-$65, but the marketed price for the combined single Trade product is nearly $2000.

Some patients avoid paying the full price for Treximet because the cost is partly covered by their health plans. But those whose plans don’t cover Treximet face the pharmacy price, which often exceeds the list price.

Pharma points to the convenience of combined drugs and the trials done to prove their efficacy as justification for the higher cost.

The article points out that most Americans often have no idea that a cheaper alternative exists. Moreover most doctors are unaware of the high markup these products carry and often do not discuss cost with their patients or discuss alternative cheaper options.

Other generic products being resold and repackaged at a much higher price in the rheumatology market include Arthrotec (combo diclofenac + misoprosti; $384), colchicine sold as Colcrys ($227) or Mitigare; and repackaged methotrexate products like Trexall (($174), Otrexup (20mg/wk $1212) and Rasuvo ($482).

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

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