Anthem's 'Think Generics' pilot nets favorable results on NSAIDs - Anthem Prescription Management - nonsteroidal anti-inflammatory drugs

Drug Cost Management Report, Oct 24, 2003

Anthem Prescription Management is expanding its generic utilization program after a pilot program resulted in a 1.7% increase in generic utilization of nonsteroidal anti-inflammatory drugs (NSAIDs).

Think Generics was piloted during the first half of 2003 in its New Hampshire markets (DCMR 4/03, p. 10). More than 800 physicians received vouchers for generic versions of Voltaren 75mg and Naprosyn 500mg. The average savings per NSAID prescription for switching to generics was $63.75.

For the entire pilot program, the difference in cost between the average generic sampled and the brand equivalent in the same therapeutic category was $67 per prescription. The program is estimated to have reduced projected health plan cost by $62,313 for the six-month period in the New Hampshire region piloted.

Other brands targeted for generic substitution by the pilot program were Zantac, Pepcid, Mevacor and Prozac/Sarafem. Anthem Prescription is still analyzing results in the corresponding therapeutic classes of acid reflux, cholesterol and depression. However, the PBM reports that the majority of samples obtained through the program were NSAIDs. The rate of generic prescriptions increased each month during the period, indicating that continued savings from generic substitutions may be expected.

In response to these preliminary results, Anthem Prescription has quickly expanded the program to Anthem members in Colorado, Indiana, Kentucky, Maine, Nevada, New Hampshire and Ohio. It will become available in Connecticut later this year and in Virginia in 2004, when Anthem Prescription becomes the PBM for Anthem's Southeast operations.

With the geographic expansion, Think Generics has also added five new medications to its generic sampling agenda. Those medications target heart disease and high blood pressure.

Anthem's results in the NSAIDs therapeutic class could have significant implications for many similar health plans. Out of 30 PBMs responding to AIS's quarterly survey of PBMs conducted exclusively for DCMR, NSAIDs represent a wide range of 1% to 30% of total drug expenditures. On average, NSAIDs account for 6.16% of drug spending for PBMs.

Call Anthem Prescription's Sharon Larrimer at (513) 336-2419.

Figure 2. Anthem Prescription's Generic
Savings on NS AIDs

Average Cost of   Average Cost of    Total Savings Per
  Brand NSAID      Generic NSAID       Generic NSAID

   $71.57             $7.82               $63.75

Source: Anthem Prescription Management

Figure 3. Medications in Anthem
Prescription's Think Generics Program

Generic        Brand Name    Dosage/            Indications
                             Quantity

Atenolol       Tenormin      25mg/28            Heart disease
                             tablets/caplets

                             50mg/28            Heart disease and
                             tablets/caplets    blood pressure

Diclofenac     Voltaren      75mg/20            Pain and
                             tablets/caplets    inflammation

Diltiazem      Cardizem      180mg/24-hour      Heart disease and
                             capsules           blood pressure

                             240mg/24-hour
                             capsules

Famotidine     Pepcid        20mg/10            Stomach acid
                             tablets/caplets

Fluoxetine     Prozac        20mg/28            Depression
                             tablets/caplets

Hydrochlor-    Hydrodiuril   25mg/28            Blood pressure and
othiazide                    tablets/caplets    water retention

                             50mg/28
                             tablets/caplets

Lisinopril     Prinivil/     10mg/28            Blood pressure
               Zestril       tablets/caplets

                             20mg/28
                             tablets/caplets

Lovastatin     Mevacor       20mg/28            Cholesterol and
                             tablets/caplets    triglycerides

Naproxen       Naprosyn      500mg/20           Pain and
                             tablets/caplets    inflammation

Ranitidine     Zantac        150mg/20 tablets   Stomach acid
                             caplets

Verapamil      Calan/        120mg/28    Heart disease
               Isoptin       tablets
                             caplets

Source: Anthem Prescription Management