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HEALTH PLANS OFFER DISCOUNTS FOR GENERIC DRUGS.

Byline: Evan Pondel Staff Writer

Four California health plans, seeking to curb rapidly rising prescription drug costs, are prodding physicians to prescribe more generic medications instead of their brand name counterparts.

In a campaign begun this week, Blue Cross of California, Blue Shield of California, Health Net of California and PacifiCare of California are participating in a program called The Generic Advantage that is attempting to improve affordability by advocating the use of generic medications. To do that, each health plan is mailing generic drug coupons to physicians that offer patients up to $10 off on their co-payments.

``Something needs to be done to protect affordability,'' said Robert Seidman, chief pharmacy officer for Thousand Oaks-based Blue Cross of California. ``This is one solution to the rapidly increasing costs. We are trying to prevent a crisis in pharmaceutical affordability.''

Sent out to 15,000 physicians, the coupons can only be used for the first prescription of certain generic medications. Under the plan, doctors will attach generic drug coupons to prescriptions that patients then present at a pharmacy within their network. The health plans said the discount will cover the entire co-payment in some cases.

``If we are able to move the needle just a little bit ... there is significant value to the health care system,'' Seidman said. ``And if we are not more efficient in the utilization of more generic drugs, we won't be able to provide affordable pharmacy benefits.''

Consumer advocates welcomed the health plans' move, touting the program's effort to promote generic medications. Gail Shearer, director of health policy analysis for the Consumers Union in Washington, D.C., said generics are a positive for the consumer and health plans.

``As a nation we need to figure out how to get better bang for our prescription dollar, and generics are a good way to do that,'' she said. ``Generics are often equivalent to high-priced brand name drugs, and one of the biggest problems we have in the health care business is getting these medications to the shelves.''

The drugs included in the program encompass several medical conditions including arthritis pain, acid reflux, diabetes, depression, high blood pressure and high cholesterol. Seidman said these conditions were targeted to broaden the coupon's reach.

Dr. Joel Teplinsky, a wound-care specialist at Encino Hospital, agrees that generic medications can often treat conditions just as effectively as their brand name equivalents, but he doesn't believe generics are always appropriate. He said that accessibility and a patients' comfort level also factor into what physicians prescribe.

``Generics are certainly less expensive for health plans, though,'' he said. ``And they are doing this because they are not providing enough prescription care coverage in the first place. This is all purely economic.''

Health Net of California spends close to $100 million annually for its members' pharmaceutical needs. The Woodland Hills-based company said the industry has been slammed by pharmaceutical drug spending.

``This is one way to help get a grip on a very powerful force,'' said Brad Kieffer, a Health Net spokesman.

Fluxoteine, the generic version of Prozac, is among the drugs included in the coupon program. Its manufacturer isn't concerned that the health plans' push for generics will woo consumers away from its popular anti-depressant.

``There is an appropriate role for both pharmaceuticals and generics,'' said Edward Sagebiel, spokesman for Indianapolis, Ind.-ba ame drug (Prozac). But we know there are opportunities for cost savings.''

The Generic Advantage coupons will be sent out this week, with the health plans conferring in September 2004 about a possible second round.

Evan Pondel, (818) 713-3662

evan.pondel(at)dailynews.com

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HEALTH PLANS VIE FOR GENERICS

SOURCE: Daily News research
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Title Annotation:Business
Publication:Daily News (Los Angeles, CA)
Date:Sep 17, 2003
Words:612
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