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Thinking About Health PDF Print E-mail
Written by Trudy Lieberman, Rural Health News Service   

Generic drug field is full of pricing traps

A friend of mine, a diabetic, stumbled on to another booby trap in the pricing of generic drugs. In my last column, I described the new two-tiered arrangements insurers are pushing on patients. You can choose a non-preferred generic and pay more, maybe a lot more, or a preferred generic and get a price break. That’s the same pricing scheme insurers use for the expensive brand-name drugs.

Consumer groups, doctors and insurance carriers have encouraged patients to choose generics over the name brands as a way to help lower the nation’s health care tab. So for many years, my friend has been using a generic drug called gemfibrozil that diabetics often take to lower triglycerides and cholesterol.

It has worked for him. No nasty drug interactions. No nasty side effects. And the price has been low ­— $2.71 for 60 pills. In August, the price more than doubled to $6.14. He was still OK with that.

He was not OK when he got a bill in September from Express Scripts, the pharmacy benefit manager for his Medigap carrier whose plan is offered by his former employer, the City of New York. (PBMs, as they’re called, manage the drug benefits for employers and insurers and supposedly help hold the line on prices.)

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Holyoke Enterprise October 23, 2014