Relief in Sight for Cost of Cholesterol-Lowering Medications

 

If you take a higher-powered medication to control your cholesterol, plan to keep more money in your pocket very soon.

 

Pfizer’s patent for its blockbuster drug Lipitor is set to expire at the end of November, 2011.

  

Fortunately, you can expect to see dramatic changes in the cost landscape almost immediately.

 

(Find practical cost-saving tips below.)

 

 

Background

Many people with high cholesterol are able to control their condition with one of several medications available in generic form.

However, not everybody takes a generic.

In particular, individuals with diabetes and cardiovascular disease have cholesterol targets that are often unreachable with the lower-priced options.  (Learn more about recommended cholesterol levels.)

There are three primary branded high-potency products prescribed today: Lipitor (Pfizer), Crestor (AstraZeneca) and Vytorin (Merck/Schering-Plough).

Although there are various opinions about the superiority of one product over another, most doctors seem satisfied with whichever medication can get cholesterol levels to goal affordably and without intolerable side effects.

 

It’s Not Over ‘Til It’s Over

Can we assume the Lipitor cash cow to be nearly dead in one year?  I wouldn’t count on it.

The Lipitor-to-generic dynamics will be far from typical.

One can predict aggressive moves to retain market share as long as possible, but Pfizer can let others do most of the initial work for them . . .

 

Salivating Insurance Companies

Not surprisingly, until now the insurance industry has pushed hard to switch patients from Lipitor to less-expensive generics.  But Pfizer will soon enjoy new bedfellows.

Expect to see strong “incentives” for individuals taking Crestor or Vytorin to switch to Lipitor immediately.  Insurance companies will aim to line everyone up for the expense reduction to be realized the first day that cheaper atorvastatin (the generic of Lipitor) becomes available. 

Healthcare providers attempting to prescribe Crestor or Vytorin in 2011 can plan to wade through an aggravating preauthorization process.  Insurance plans will almost certainly refuse to cover the other branded medications until individuals have first tried and “failed” both Lipitor and a generic alternative.  They know quite well that rationing through inconvenience is very effective at swaying prescribing patterns.

 

Nervous Competitors

The full court press to switch everybody to Lipitor will quickly impact AstraZeneca and Merck/Schering-Plough.

Expect a bombardment of advertising and discounts to entice patients to remain with their products.

However, the effort might be futile–Pfizer has an ace in the hole.

 

If You Can’t Beat Them, Join Them

Pfizer is not stupid.  There is too much money riding on this to simply enjoy a temporary boost in sales only to roll over dead one year from now. 

So, how does one compete with an impending generic?  They apparently have it at least partially figured out.

Hot off the press is the new Lipitor $4 Co-Pay Card.  For most insured individuals, this will all but negate the lure of the discount pharmacies like Walmart and Target.  Furthermore, the $4 co-pay program will continue at least through all of 2012.  Yes, that means that most people will be able to remain on branded Lipitor for $4/month even after the emergence of generic atorvastatin. 

Very clever.  Maybe 12/1/2011 won’t be the insurance company payday that was expected.

   

Your Game Plan for Savings 

  

If you are taking Crestor or Vytorin and covered by insurance:     

  • Fully expect strong pressure from your insurance plan to switch you to Lipitor over the next 6-12 months.
  • Be sure your healthcare provider is aware if you have already “failed” Lipitor.  They will likely have to explain it to your insurance company.
  • If you are considering giving Lipitor a try, now might be the cheapest time to do so.  Take advantage of the $4 Co-Pay CardEven better, try it for free–Pfizer is still showering doctors’ offices with samples.
  • If you take Crestor: Take advantage of the Crestor Support Program.  After signing up you will receive a card to reduce your co-pay to $25/month. 
  • If you take Vytorin: Although not available online, your healthcare provider likely can give you the Vytorin Multiuse Savings Card than will reduce your co-pay for the next six refills.  It is good through the end of August, 2011.
  • Check these links for coupons for a 30-day free supply of Crestor and a one-month free supply of Vytorin.  Know that they are labeled as “free trials” and pharmacies that have previously filled Crestor or Vytorin prescriptions for you may not honor them.
  • Your healthcare provider likely also has unused free samples of Crestor and Vytorin, as they have been flowing freely and should continue to do so through 2011.
  • Keep your eye on the Crestor and Vytorin websites, as it would not be surprising to see additional savings promotions come available over the next several months.

If you already take Lipitor and are covered by insurance:

  • Get the new Lipitor $4 Co-Pay Card.
  • Although not available online, many healthcare providers have coupons for 30-day free supplies that are good through 2011.
  • Free samples of Lipitor may soon dry up, but they are currently available in great numbers.
  • Rejoice that immediately this medication will make a much smaller dent in your wallet.

If you take Crestor or Vytorin and are covered by a government program (traditional Medicare, Medicaid, etc.) or are a Massachusetts resident:

  • Unfortunately federal anti-kickback laws and Massachusetts statutes prevent you from using the co-pay cards.  Pharmaceutical companies are prohibited from providing you discounts or rebates on their products.
  • However, many contend that the regulations do not prevent them from giving their products away for free.  Check out the coupons described above for a 30-day free supply of Crestor and a one-month free supply of Vytorin
  • Of course, you to can make use of the free samples currently available for any of the three products.

If you do not have insurance:

  • If you take Crestor: The Crestor Support Program allows uninsured individuals to save $25/month. 
  • If you take Vytorin: Although not available online, your healthcare provider likely can give you Vytorin Multiuse Savings Card than also allows uninsured individuals to save $25 on up to six refills.  It is good through the end of August, 2011.
  • If you take Lipitor: Many healthcare providers have coupons for 30-day free supplies that are good though 2011.
  • Check these links for coupons for a 30-day free supply of Crestor and a one-month free supply of Vytorin, as detailed above.
  • Talk to your healthcare provider about pill splitting.  All three branded products are relatively “flat priced,” meaning that the cost is similar regardless of the pill strength.  Splitting the next-higher dosage can cut costs in half.
  • Consider whether a currently available generic product might be a reasonable option for your situation.

Notes:

  • If you currently receive medications from a bulk mail-order pharmacy, you will most likely need to temporarily use a local pharmacy to take advantage of savings promotions.
  • The above information should not be construed as medical advice.  These are only tips related to cost savings.  Discuss with your healthcare provider the appropriateness of any potential medication changes.
  • Author disclosure: I have no significant business relationship with Pfizer, AstraZeneca or Merck/Schering-Plough.

Stephen Meyers, MD

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2 Comments

Filed under High Cholesterol, Uncategorized

2 responses to “Relief in Sight for Cost of Cholesterol-Lowering Medications

  1. Sandra

    good information

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