WellPoint markets generics to physicians and members

Drug Cost Management Report, Feb, 2003

WellPoint Health Networks has implemented GenericSelect[SM], a new program to encourage utilization of generic drugs among members and prescribing physicians. The driving incentive is a discount of up to $10 off the patient's copay the first time they begin a new drug therapy with a GenericSelect drug. Some patients may even qualify for a full copay waiver depending on their benefit plan. Eligible members will receive a discount by presenting a first prescription for a GenericSelect drug at a participating pharmacy.

WellPoint's program focuses on 11 generic formulary drugs intended to replace the equivalent brand, non-formulary drugs. These drugs are regarded as safe and effective, as well as a "value-added alternative," according to Dr. Robert Seidman, WellPoint's chief pharmacy officer.

Note that WellPoint's program specifically targets a number of high blood pressure drugs. Hypertension drug products account for almost 7% of PBMs' total drug expenditures, yet not many drug cost management programs are in place that specifically target these products.

GenericSelect is intended to increase awareness of generic drug value, and to counteract any marketing loss due to patent expirations. Seidman points out that the marketing of brand-name drugs to both patients and physicians disappears when patents expire, and that the selected generic drugs are no less effective than their brand equivalents. According to the FDA, brand-name drugs and their generic equivalents have the same approval requirements, and are equally safe and effective, since they contain the same active ingredients.

Rather than bemoaning pharmaceutical marketing strategies, Seidman appears to credit this marketing for the widespread health benefits gained from utilization of prescription drugs. Therefore, generic drugs maybe worth a marketing campaign for the financial and clinical benefits to members.

WellPoint does not intend to hinder physician prescribing authority or prescribing patterns with this program, according to the Woodrow Myers, MD, the MCO's chief medical officer. In addition to controlling members' out-of-pocket prescription costs, the program is designed to facilitate communication between members and physicians regarding prescription drug alternatives.

The program follows the FDA and the BlueCross BlueShield Association's recent efforts to educate consumers on the safety and efficacy of generic drug alternatives. GenericSelect is also reminiscent of AdvanceGenerics, a program launched by AdvancePCS in August 2002 that provides plan members with vouchers allowing them to obtain the first fill of a generic drug at a retail pharmacy with no copayment.

WellPoint subsidiary Blue Cross of California has Already begun marketing the GenericSelect program to its 6.8 million members. After just one letter from Well Point to physicians and members about switching to Mevacor for high cholesterol, utilization rose from less than 1% to 4%, according to Seidman.

For more information contact: Larry Bryant, (805) 557-6792, larry.bryant@wellpoint.com.

Figure 5. The 11 Drugs Available
Through GenericSelect

                      Equivalent
GenericSelect Drugs   Brand-Name Drug    Indications

Fluoxetine            Prozac             Depression
Lovastatin            Mevacor            High Cholesterol
Ranitidine Tablets    Zantac Tablets     Acid Reflux
Lisinopril            Zestril/Prinivil   High Blood Pressure
Atenolol              Tenormin           High Blood Pressure
Metroprolol           Lopressor          High Blood Pressure
Hydrochlorothiazide   Oretic             High Blood Pressure
Chlorthalidone        Hygroton           High Blood Pressure
Metformin             Glucophage         Diabetes
Ibuprofen             Motrin             Arthritis Pain
Naproxen              Naprosyn           Arthritis Pain

Source: WellPoint Health Networks, Inc.