What Will Happen With Generic Lipitor (atorvastatin)?

Well, it finally looks like generic Lipitor will be on the market soon.  I think November 30th is still the date.

Of course, now the question is what will this mean to you (the consumer)?  Since atorvastatin will be distributed by only one manufacturer for the first six months after the patent expires, there will not be a significant price drop.  Therefore, I know at least one (and have heard two) PBMs will be blocking the generic drug during that time.  Consumers will be able to get Lipitor at a generic copay.

I’ve offered my opinion on scenarios like this before.  I think it’s confusing to the consumer.  It’s great for Pfizer and generally everyone wins since it’s the same out-of-pocket costs to the consumer and lower cost to the plan sponsor (employer) than the exclusive generic (due to rebates), BUT I think it sends a confusing message.  “You can and should use generics except for in some cases where the brand drug is cheaper.”  I’m not sure how this plays out in states where generic substitution is required by law.

Of course, your other option is to go use the Lipitor $4 coupon.  If I were the Pfizer brand manager for Lipitor, I would offer a $50 payment for a 1-year supply of Lipitor and lock people in for the year.  [A seperate discussion needs to be had about how cash and coupon claims which don’t necessarily get adjudicated affect adherence measures for bonus payments like Star Ratings…and yes, I know that coupons aren’t supposed to be used for Medicare members, but I don’t think that’s monitored well.]

So, you might go to get your generic Lipitor and leave with the brand at your generic copay.  On the other hand, I wouldn’t be surprised to see some PBM negotiate well enough to get a better price on the generic than Lipitor (net of rebate).  [Of course, these are the types of scenarios that cause friction in the supply chain.  Which drug can the retailer buy better?  Does the client get the rebates shared with them or not?]

I know this is what some companies like GoodRx are looking at with their application which compares drug prices across retailers.  It shows you if there’s a coupon available (see broader article on them).  It suggests savings like splitting the pill.  (No mail or 90-day promotion yet that I saw.)  Of course, this is from a cash paying customer perspective.  But, with atorvastatin, you may want to compare your plan design with the cash price with coupons.  You’ll want to know if it’s part of the $4 generics program or if you get a better price with the CVS or Walgreens discount card programs.

Here’s two examples from GoodRx.  One is for Lipitor which shows some variation (and has no generic today).  The other is for Prozac which has been available as a generic for a while.

One Response to “What Will Happen With Generic Lipitor (atorvastatin)?”

  1. George – I’ve done quite a bit of research into the issue of “mandatory generic substitution” states. The fact is that states do not mandate “generic” substitution. The laws in those states consistently and uniformly require the pharmacist to dispense the “less” or “least” expensive product. Since historically, the generic has been the less expensive product, there’s been an assumption that it’s a mandatory “generic” substitution requirement. (Only Minnesota uses the word “generic” and in that state, they allow healthcare plan coverage to override the substitution requirement.) It would be more appropriate to refer to those laws as “mandatory less expensive product selection” laws.

    Ironically, and apropos for the Lipitor situation” If the generic is blocked and the brand placed at Tier 1, the generic will be more expensive to the consumer than the brand. In that case, it will violate those “mandatory” laws if the pharmacist substitutes with the generic (since it will not be the less expensive or least expensive drug.)

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