Public Employee Press

News about your benefits
No co-pays for generic cholesterol drugs

Beginning in January, members and retirees with prescriptions for cholesterol-lowering drugs known as statins won’t be charged co-pays for the generic versions of their medications.

“This new zero co-pay program will help the union’s prescription drug program save money while it cuts members’ costs during these difficult economic times,” said Cynthia Chin-Marshall, administrator of the DC 37 Health & Security Plan. “Generics are a safe alternative to brand-name drugs, but you need to discuss any change with your physician.”

In the year that ended on June 30, the plan handled almost 200,000 claims for statins, which make up the greatest portion of the $165.7 million the plan spends on drugs each year. The popular Lipitor is the plan’s most frequently used medication.

Brand-name statins cost the plan an average of $159.70 a month, while generics cost only $2.39 a month. The plan covered $17.3 million in claims for the brand-name drugs — 59 percent of the statin claims — but under $179,000 for generic statins, which account for 41 percent of the claims.

Generics are available for frequently prescribed statins, such as Mevacor (generic: lovastatin), Pravachol (pravastatin) and Zocor (simvastatin). After Lipitor’s patent runs out in 2011, the drug manufacturer Pfizer will be allowed to sell a generic version for six months until competitors can bring cheaper versions to the market.

DC 37’s prescription drug plan encourages participants to use generic drugs by offering a three-tier co-payment structure. Participants pay $5 for a month’s supply of generics, $15 for brand-name drugs on a list of preferred medications and $35 for nonpreferred brand-name drugs.

While some unions and employers have mandatory generic plans requiring employees to pay 100 percent for brand-name drugs that have generic equivalents, participants in the DC 37 plan pay the $35 co-pay and pay the difference between the ingredient cost of the brand-name drug and the generic.

Consumers have become more willing to use generics as the federal government and drug plans have done a better job of educating people about their safety and effectiveness. Affordability provides a big incentive to use generics, because they typically cost only one-third as much as brand-name drugs.

The strength and active ingredients of generics match the brand-name versions, and the federal Food and Drug Administration tests generics before they are sold.

— GNH