Generic Drug Effects on the Market
What is the expected growth of the generics market in the near future?
According to IMS Health, the generic industry is growing at more than 7%, a pace that is faster than the world pharmaceutical market. Fueling continued growth will be the strong utilization of generics through the Medicare prescription drug benefit (Part D), an aging population needing affordable medicines, and more than $50 billion in brand products that will be coming off patent during the next few years. How has the U.S. market grown?
In 2007, U.S. manufacturer sales of generics reached $58.5 billion. Total 2007 U.S. pharmaceutical manufacturer sales -- for brand and generics -- were $286.5 billion. [Source: IMS Health] What is the generic substitution rate?
65% of all prescriptions dispensed are generics, yet they only account for 20% of all pharmaceutical expenditures. Generics cost, on average, 30% to 80% less than their brand counterparts. How are drug prices affected when generics enter the market?
Tabulations of average retail prescription prices in 1994 show that the average price of a generic drug does decline as the number of manufacturers and distributors of that drug increases. For example, the average prescription price of a generic drug with one to five manufacturers ($23.40) is more than that of a drug with 16 to 20 manufacturers ($19.90). CBO's retail pharmacy data set covers 112 innovator drugs that in 1994 were also available in generic forms sold under their chemical name. Comparing the average generic prescription price with the average innovator price for the same drug also shows prices falling as the number of generic manufacturers rises. When one to 10 generic manufacturers are in the market, the generic retail prescription price averages 61 percent of the brand-name price. When 11 to 24 generic manufacturers are in the market, the generic retail price averages less than half of the brand-name price. [Source: July 1998, CBO: How Increased Competition from Generic Drugs Has Affected Prices and Returns in the Pharmaceutical Industry] How many generic companies are there? U.S. and worldwide?
There are roughly 50 U.S.-based finished-dose form manufacturers of generic pharmaceuticals. The generic industry employs tens of thousands people. The top five U.S. corporations by unbranded generic prescriptions dispensed are Teva Pharmaceuticals USA, Mylan Inc., Novartis (Sandoz), Watson Pharmaceuticals, and Barr Laboratories, Inc., respectively. [Source: IMS Health, National Sales Perspective and National Prescription Audt, Nov. 2007.] What generics have been approved recently?
Since there is a lag time after generic products are approved and they appear in the Orange Book, you can review the most recent monthly approvals on the FDA's "First Generics" listing.
Copyright 2008. Generic Pharmaceutical Association (GPhA) 2300 Clarendon Blvd. Suite 400, Arlington, VA 22201 (703) 647-2480 http://www.gphaonline.org/Content/NavigationMenu/AboutGenerics/FAQs/faqs2.htm
With ScripNet, pharmacies are connected to an online adjudication
system so that coverage for prescriptions can be verified immediately.
Thanks to this entirely automated process, ScripNet, with about 35
employees, is able to negotiate discounted rates and reduce paperwork,
thereby saving its clients time and money.
Several years into its contract with ScripNet, the Texas Association
of Counties has seen savings reach more than $250,000 in one year, mainly
from the utilization of network pharmacies and the paperless, hassle-free
environment
Landing on Inc. Magazine's top 500 list of fastest growing privately held companies in America takes planning and a sense for business. For Dennis Sponer, success meant filling a niche where there was a gap in services.
It's three down and two to go for Las Vegas-based Pharmacy Benefit Manager (PBM), ScripNet. The seven-year-old PBM has thrice made the cut for Inc. magazine's 500 fastest growing privately-owned companies, putting them just two rankings away from the glossy's Hall of Fame archive.
What do a prescription-drug processor and an online shoe store have in common?
Both Las Vegas-area enterprises were among the top 25 companies making
Inc. magazine's list of the 500 fastest-growing privately held
companies.
The traditional method of trafficking in paper prescriptions to supply drugs in worker's compensation claims is labor-intensive and hazardous, Sponer said. It took time to interpret stacks and stacks of claim papers and shelf after shelf of space to store it. Paper also left room for mischief, he said; the unscrupulous could fashion phony claims or illegally copy legal ones, changing the date to get unauthorized medicines.
Eliminate the paper, he figured, eliminate the problem. To do so, he started ScripNet, a company managing pharmacy benefit claims electronically.
[Prescription Drug Service] is provided through ScripNet,
a preferred provider organization (PPO) that has a network of more
than 40,000 pharmacies nationally. ScripNet specializes in pharmacy
benefit management and is devoted to containing the rising cost
of health care delivery.
Texas Mutual partnered with ScripNet to launch the program. ScripNet, which provides pharmacy managed care services exclusively to workers' compensation insurance carriers, has a network of 2,400 pharmacies in Texas, and more than 40,000 nationwide.
Dennis Sponer is an attorney by profession. He is well aware that sometimes people do not receive the compensation they deserve as quickly as they should receive it.
His goal is to make sure that people receiving workers' compensation do not have to jump through any unnecessary hoops.
Partnership with ScripNet brings convenience for claimants, savings for agencies.
Nevadan At Work: Dennis Sponer
Paper not in script for Scripnet boss...
Rising Stars: Kelly Schick: ScripNet
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ScripNet is in the business of cutting the costs of prescriptions to reduce the cost of workers' compensation claims. Kelly Schick brings 20 years of a sales and medical background to the table in her role as the company's national sales manager.
Ask Our Pharmacist
| Ask Our Pharmacist - Actiq
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Ask Our Pharmacist
John F. Aforismo B.Sc. Pharm., R.Ph.
Clinical Pharmacist
Question:
The use of Actiq and now Fentora, two high cost narcotic pain relievers, is becoming a growing concern. Are these products appropriate for the management of acute and chronic pain due to injury and what steps can be taken to help minimize the financial impact that Actiq and Fentora presents?
Answer:
Simply put, the use of Actiq and Fentora, are not appropriate treatment options for pain management for individuals that have sustained an industrial injury. These are powerful medications that, as recently as late 2007 had received many reports of serious adverse events including some deaths in patients who were not appropriate candidates for Actiq and Fentora. These events appear to have occurred as a result of improper use in patients who were not already taking opioids around-the-clock (opioid nontolerant); improper dosing of the medication; and/or improper substitution of Fentora for other fentanyl-based medications.
Both Actiq and Fentora are only FDA approved for the management of breakthrough pain in patients with cancer who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain.
In addition, these products carry very serious "black box" warnings, including but not limited to:
- Must not be used in opioid non-tolerant patients
- Contraindicated in the management of acute or post-operative pain
To minimize the financial impact of Actiq and Fentora, physicians, claims adjusters, case managers and payors will need to determine, is it clinically appropriate to use Actiq or Fentora?
It is our recommendation that these agents are only to be utilized when, in the rare case, an individual has failed all other clinical options. Currently there are a myriad of medications which are appropriate alternatives to provide relief of acute breakthrough pain. Short acting narcotic pain relievers (i.e. Percocet, Roxicodone, etc) or Anti-Inflammatory Agents (such as Ibuprofen, Voltaren, etc) are generally safe and effective starting points. Upon subsequent evaluation, it may be determined that the addition of a long-acting pain reliever (i.e. OxyContin, MS Contin, etc.) is appropriate to help reduce the need for many daily doses of rescue short-acting pain medications. Continuous monitoring and assessment of the patient's pain management will allow for dose adjustments if and when necessary, greatly reducing the need to administer products like Actiq and Fentora.
Ask Our Pharmacist ? Actiq ? March 30, 2008
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| Q&A With ScripNet's Clinical Pharmacist
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Ask Our Pharmacist
John F. Aforismo B.Sc. Pharm., R.Ph.
Clinical Pharmacist
Question:
With generic OxyContin? now no longer available from generic manufacturers and as supply in the marketplace (wholesaler and pharmacies) diminishes, What steps can be taken to help minimize the financial impact that OxyContin? presents?
Answer:
As of February 1, 2008 the last of the generic manufactures (Teva Pharmaceuticals) have ceased sales and distribution of their generic version of OxyContin? (oxycodone controlled-release) tablets. This means that whatever product is in the marketplace, both at the wholesaler and pharmacy level is all that remains. Once this supply is exhausted, the generic product will be gone until the expiration of OxyContin?s? patent in April of 2013.
To minimize the financial impact of Oxycontin?, physicians, claims adjusters, case managers and payors will need to determine, when is it clinically appropriate to use OxyContin??
It is our recommendation that no long-acting (controlled released) narcotic pain reliever be prescribed as a first line agent, roughly the first 30 days after an injury. It is recommended that it would be best to treat with short acting narcotic pain relievers (i.e. Percocet?, Roxicodone?, Tylenol with Codeine?, etc) or Anti-Inflammatory Agents (such as Ibuprofen, Voltaren?, etc) to allow for a proper assessment of the Injured Workers? condition. Once an initial assessment has been performed, patient response to the short acting medications has been determined (side effects and positive outcomes), then and only then, will the administration of OxyContin? and other long-acting narcotic pain reliever be considered an appropriate choice of therapy.
By conducting this baseline assessment, the use of costly powerful long-acting narcotics may be averted.
February 2008 JFA ScripNet Clinical Pharmacist
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Service
"ScripNet was the flexible and individual based type of service that could benefit HISD."
Tom Dolan
Claims Manager
Houston Independent School District
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