Public Employee Press

As brand-name patents expire, save with generics

The patents of a number of widely used brand-name drugs have expired recently, and more will end over the next year.

That means generic versions will be available, and members and retirees who use the brand-name drugs will pay more out-of-pocket unless they switch to generics.

DC 37 Health and Security Plan participants must use a generic drug whenever one is available to avoid a higher expense.

The plan has $35 co-pay for brand-name drugs that are not on the preferred list. But if a generic version is available, you’re charged not only the co-pay but also the difference between the cost of the brand-name drug and the generic equivalent.

As patents expire, the plan’s prescription benefit administrator, Innoviant, generally allows a three-month grace period before imposing the higher cost.

The plan has a maximum $5 co-pay for pharmacy purchases of 30-day supplies of generics and $15 for preferred medications. “We want our participants to be aware that they could pay more if the patent of their brand-name drug runs out and there is a generic version,” said Rosaria R. Esperon, administrator of the plan.

The chart (at right) gives participants a heads-up about generic equivalents that have come on the market recently or will be released within the next year. Some of the drugs are widely prescribed, including Pravachol and Zocor (for cholesterol), Zoloft (depression), Ambien (sleep disorder) and Flonase (allergy).

By using less costly generics, participants can cut their drug expenses and hold down the plan’s costs. Though individual reactions to medications may vary, patients generally don’t sacrifice quality or effectiveness with generic drugs. Over the years, drug costs have increased much faster than the rate of inflation, putting great financial pressure on the union benefit.