Up is Down and Generics are Fair Game


The standard advice for consumers – “Always ask if there is a cheaper generic!” – has for years saved patients big money at the pharmacy counter. Now, Big Pharma is fighting back. The conventional wisdom about how to lower drug costs is today often wrong as pharmaceutical companies cut deals with PBMs in order to squeeze the last profits from products that are facing cheaper generic competition.

Writing for the New York Times, Charles Ornstein and Katie Thomas offer a fascinating look at those deals – deals affecting drugs such as the cholesterol treatment Zetia, the stroke-prevention drug Aggrenox, and the pain-relieving gel Voltaren. In each case (and in many more) we see insurers and pharmacy benefit managers insisting that consumers forgo generics to buy brand name drugs that cost more – both for patients and for their self-funding employers.

The authors’ principal focus is Shire Pharmaceuticals. Adderal XLl had been for years the company’s top-selling product, bringing about 1/3 of its revenue in 2008. In order to protect that market share, Shire sued generic drug companies and then made deals to supply them with pills (to be sold as “generic” in exchange for a share of royalties). When it came time to make good on those agreements, Shire failed to supply its partners with enough pills to compete in the marketplace.

More recently, Shire has been “giving ever-larger discounts to pharmacy benefit managers and insurers for preferential treatment over the generics.” That did not mean lowering the list price of the drug, but rather negotiating rebates that were paid not to the patients [or their employers] but to insurers and middlemen such as United Healthcare and CVS Caremark.

These deals may benefit shareholders, but patients are feeling the pain. 29% of Americans with health insurance paid for by their employer now have a high-deductible insurance plan, and so they often must pick up the full sticker price of these medications – until they have paid out thousands of dollars.

Read the rest of this fascinating article in the New York Times: 

Take the Generic, Patients Are Told. Until They Are Not. 


40 Grove St, Suite 270 Wellesley, MA 02482

  • LinkedIn - White Circle
  • Facebook - White Circle
  • Twitter - White Circle
  • YouTube - White Circle


© Copyright 2020 Scripta Insights, Inc. 

Scripta™ is neither a pharmacy nor a doctor. The benefit service does not tell you what drug to take and does not participate in the drug selection process. Only your physician can determine the medications that are right for you. These alternative medications are options for less costly drugs that physicians may prescribe in place of the medications you are taking now. Scripta has reviewed your current medications only for the purpose of identifying potential cost savings for you to consider with your physician. Scripta has not analyzed the effectiveness or other therapeutic aspects of these medication alternatives. Accordingly, this report and any other forms of communication received from Scripta are not, nor should they be interpreted as, any form of treatment, drug regimen review, or provision of counseling or consultation by a prescriber, pharmacist or pharmacy. Do not stop taking your medication, change your medication, or start taking a new medication without being directed to do so by your physician and filling the prescription under the oversight of a licensed pharmacist. The alternatives set forth above may not be equivalent to your current medication, may interact adversely with your other medications, may not be indicated in light of your other conditions, may cause different or severe side effects, or may be less effective at treating your condition. Medication prices are approximate based on information provided by your pharmacy benefits manager, insurance plans, and/or employer, and may vary from pharmacy to pharmacy. Check with your insurance plan to obtain a full list of pharmacies where your prescriptions can be filled. All information herein is HIPAA protected, treated as highly confidential, and never shared with your employer.

Scripta™, Scripta Insights™ and The Best Meds at the Best Price® are registered trademarks of Scripta Insights, Inc. The contents of the site are for informational purposes only and not intended as a substitute for professional medical advice, diagnosis, or treatment. We do not recommend or endorse any specific prescription drug or pharmacy that may be mentioned herein. Reliance on any information provided by us, our affiliates, employees or others is solely at your own risk.