The Official Medtipster Blog

www.Medtipster.com Source: WalletPop.com, by Barbara Thau – 2.15.2011

As the economy still muddles through a funk, the price of prescription drugs continues to soar. in fact, drug prices are the fastest growing chunk of consumers’ healthcare expenses, according to the non-profit Families USA.

But there are myriad ways to meaningfully trim your prescription drug bill. From generic drugs to assistance programs — here’s how to save on your meds — and do so safely.

Avoid Brand Names

To slash as much as 70% off the price of your medications, buy generic.

“If you are given a prescription for a brand name drug from your doctor, it’s always good to ask, ‘Is there a generic equivalent for this drug?’ ” says Jody Rohlena, senior editor at Consumer Reports’ ShopSmart.

A recent report by Best Buy Drugs, a division of Consumers Union (Consumer Reports’ parent company), examined the safety and effectiveness of prescription medications and found that generics are as safe and effective as brand names.

Tap Low-Cost Prescription Programs (Located On Medtipster.com)

Take advantage of the price war being waged among national discounters and supermarket chains for generic prescription medications.

Walmart, Target and Kroger charge $4 for a month’s supply on hundreds of generic drugs. Some other options, recommends ShopSmart, include Costco, Kmart, Drugstore.com and Walgreens, which also run reputable and highly-affordable discount drug programs.

To save a few extra dollars, ask your doctor for 90-day prescriptions. Walmart, for example, offers $4 for a month’s supply and $10 for a 90-day supply. With buying in bulk, the savings will add up as you fill more prescriptions and it will also save you trips to the drugstore.

‘Splitting’ the Cost

If you take prescription drugs to treat a chronic illness, you might be able to save money by splitting your pills — literally cutting them in half. With prescription medication costs soaring, many doctors are advising patients to do just that.

Pill-splitting can save money because pharmacies routinely charge roughly the same amount for a particular medication, regardless of the dose. But don’t go it alone: It’s crucial to consult your doctor about splitting your pills as not all medicines can be safely divided.

For example, a once-a-day drug may cost $100 for a month’s supply in either a 100-milligram dose or a 50-mg dose. If your doctor prescribes the 50-mg pill, it will set you back $100. But if your doctor prescribes the 100-mg pill and instructs you to cut it in half, $100 will get you two months worth of the medication, according to The Shoppers Guide to Prescription Drugs: Pill Splitting, a report from Best Buy Drugs.

Pill-splitters cost between $5 and $10 and can be found in most drugstores.

Although the American Medical Association opposes the practice, they acknowledge that many pills can be split safely if done correctly, the Best Buy Drugs report says.

Ask for Help

If you’re having trouble paying for medication, let your doctor know.

A physician can help spell out your options, such as financial help through your insurer, if you have one, and patient-assistance programs that you might qualify for.

Some pharmaceutical companies also provide free and low-cost medications to people who cannot afford to pay for medications.

RxAssist offers a database of such programs, as well as ways to manage your prescription drug expenses. DestinationRx is another source, with price comparison tools and guidance on drug-purchasing options.

Rx Savings for Seniors

The quest for affordable medication takes on a heightened sense of urgency when it comes to seniors: Most seniors are on a fixed income and are among the biggest consumers of prescription drugs, representing 34% of the prescriptions filled in the U.S., according to Families USA.

High costs mean that many seniors “have had to make some tough decisions in terms of taking their medicines,” says David Allen, a spokesman for AARP.

Now the government is offering some relief. A provision in the new healthcare law is designed to take a bite out of what’s known as “the doughnut hole,” and over time close the coverage gap on prescription medications.

As things were last year, once seniors spent $2,830 on medication, they had to pay 100% for their prescriptions until they reached the $3,610 threshold — a financial hardship for many older Americans. Now, when they reach the $2,830 threshold, the government will chip in 50% of the cost for brand-name drugs and 7% for generics, Allen says. By 2020, the doughnut hole will cease to exist, says Allen.

If you’re on Medicare, keep track of your particular prescription costs with AARP’s Doughnut Hole Calculator.

Use it to alert you when you’re nearing the coverage gap. It also will offer a list of alternative, lower-cost drugs based on your prescription drug profile that you can take to your doctor to discuss whether switching to a lower-cost drug will work for you.

In addition, AARP provides a handy Drug Savings Tool link where consumers can compare a drug’s efficacy and price against alternative medications listed by Best Buy Drugs.

Buyer Beware: Pharmacy Fraud

Pharmacy fraud is alive and well and living on the Internet. Scam artists are there seeking money, or personal information to commit identity theft.

These types of predators mostly hunt their prey online, says Sally Hurme, senior product manager of education and outreach for AARP, who tracks pharmacy scams that target the entire drug-purchasing population.

When an online offer seems too good to be true, it probably is. An email offer for prescription medications at bargain basement prices (that does not come directly from a well-known retailer or your health insurance company) is most likely a scam, Hurme says. And email that says “Viagra for $10″ or “Prilosec for $5,” for example, should go right in your email trash — chances are that it will wind up in your spam folder anyway.

Scam artists often masquerade as online pharmacists. They woo consumers to pay upfront in exchange for a supposed drug discount card. Shoppers who “order” their medications receive nothing at all, or drugs that are compromised in some way — be they expired or at the wrong dosage.

Be skeptical. Before filling a prescription online, be sure that the pharmacy requires a doctor’s prescription. And never provide your personal information — such as your Social Security number, credit card or health history — to a website unless you’ve verified that it’s secure, says AARP.

www.Medtipster.com Source: PharmaSueAnn - 2.15.2011

37% of customers are never quite sure which cold medications to take for their symptoms. It’s a finding that doesn’t surprise the pharmacists. 

PharmaSueAnn says the most common complaints right now are “stuffy nose, headache, cough in the chest.” For the stuffy head and sinus pressure she recommends a decongestant. “The decongestant works on actually the blood vessels in your sinus passage” explains SueAnn, “there’s loads of blood vessels in there and it causes them to constrict which makes you feel less stuffy.” It also causes the mucus to drain.

On the opposite end, the runny nose and allergy-like symptoms SueAnn says to reach for an antihistamine. “The antihistamine would come in if you’re experiencing watery eyes like you would get with a cold or you’re sneezing a lot.”

An antihistamine can cause drowsiness, so it’s often found in nighttime cold relievers.

For a general pain reliever the advice is aspirin, acetaminophen or ibuprofen. Ibuprofen is an anti-inflammatory as well, so SueAnn says it will also help relieve sinus pressure.

If it’s a cough bring you to the pharmacy aisle says SueAnn, “I would need to know what kind of cough you’re speaking of. Are you speaking of a rattling chest cough where you have phlegm coming out or is it just a dry annoying cough.” For the rattling cough she says to look for guafenisen on the label or cough expectorant. It helps to break up chest mucus. For the dry cough grab a cough suppressant.

And when using a multi-symptom reliever, be careful when taking additional meds warns SueAnn, “you don’t want to double up on your Tylenol because it could cause liver damage.”

And finally, when using products that contain zinc meant to shorten the duration or reduce severity, SueAnn says you need to take it at the first signs of the cold, if it’s taken too late “they’re just throwing their money away.”

Keep in mind, if you’re already on something like a blood thinner or arthritis meds check with your pharmacist when grabbing an over the counter remedy. SueAnn says it’s not safe to take ibuprofen with those types of drugs. And if you can’t kick the fever with an over the counter, it’s likely a bacterial infection that may need an antibiotic

www.Medtipster.com Source: The Wall Street Journal, 1.31.2011 – By Goran Mijuk

Generic drug makers are expecting copies of complex biological drugs to become a multibillion dollar market in the near future. But a lack of clear regulation, intense scrutiny from makers of the original drugs and the high cost of research may damp their prospects.

Hopes that the U.S. and European market for these copies, known as biosimilars, will thrive are based on the fact that biological drugs with more than $60 billion in annual sales will lose patent protection by 2015, according to research firm Datamonitor.

Should the market develop according to plan, copies of these complex drugs alone could make up around 50% of the expected $10 billion biosimilars market by 2016, according to data compiled by Capgemini Consulting. The rest will come from simpler biosimilars, such as copies of insulin and human growth hormone.

Biological drugs are made of larger molecules than chemical drugs. They are generally more effective in treating diseases such as cancer but are more expensive because of the high costs involved in making them.

Among those with patents due to expire soon are Roche Holding AG’s blood cancer and rheumatoid arthritis medicine Rituxan, also known as MabThera, anti-inflammatory drug Remicade, which is co-marketed by Merck & Co. and Johnson & Johnson, and Amgen Inc.’s and Pfizer Inc.’s rheumatoid-arthritis drug Enbrel. Each drug had more than $5 billion in annual peak sales.

The European expiry in 2014 of Roche’s Rituxan, a complex monoclonal antibody, which allows for the direct targeting of affected cells, has recently prompted three generic players to start research on a copy. Novartis AG’s generics unit, Sandoz, said it has started midstage trials for the drug, following similar steps by U.S.-based Spectrum Pharmaceuticals Inc. in early January and Israel-based Teva Pharmaceutical Industries last year.

Sandoz, which is leading the market for biosimilars with a roughly 50% market share, ahead of Teva and U.S.-based Hospira Inc., expects the entire biosimilars business could reach more than $20 billion by 2020, up from a current $250 million. Swiss chemicals company Lonza Group AG, which is teaming up with Teva in its biosimilars venture, expects solid growth because patients, insurance companies and governments want drugs to be cheaper.

The generics companies base their argument on the high price of many complex biological medicines. Treatment with Roche’s lung and kidney cancer drug Avastin and the colorectal cancer drug Erbitux from Germany’s Merck KGaA can cost thousands of dollars a month. But some experts question the generics companies’ pricing rationale, saying the current constraints could even force larger generic producers such as Sandoz or Teva to rethink their operating models.

“Much will depend on how the price of these drugs will develop,” says David Kaegi, pharmaceuticals analyst at Bank Sarasin. “Depending on the price, operating models will have to be adjusted.”

He says prices for biosimilars could be just 30% lower than the prices of the originals, because only a couple of generics firms will compete against an original drug. “It thus won’t be like in the case of the simple generics, where many firms moved into the market and prices were aggressively cut. It will be more difficult,” he says.

Since generics of chemical drugs, which are made of small molecules, are relatively simple to copy, the market for generic drugs attracted a flurry of players and this brought prices down sharply.

The main risk, analysts say, is that if prices don’t come down much, original drug producers will be able to retain a large market share. On the other hand, if prices fall too fast, generics firms’ margins could suffer.

A Sandoz spokesman said the company expects pricing to continue to vary according to product and market, saying the entry bar for complex products would be high, which would limit competition and keep prices from falling too fast. Lonza’s chief executive, Stefan Borgas, said that even if prices fell by 50%, margins and growth would still be healthy.

Industry insiders and management consultants are also concerned the market may need longer than expected to establish itself, as research and development for these complex drugs is difficult and costly, and doctors and patients may be wary about their safety.

One of the main problems with generic versions of complex biological drugs is that, unlike simple-to-produce generics of chemical drugs, which are identical to the originator product, these medicines aren’t exact copies. Complex biological drugs such as Rituxan are genetically engineered and consist of large molecules produced in live cells.

Because the manufacturing process is difficult, requiring extensive genetic expertise, and it is also prone to errors, continuous testing and controlling is needed. At best, a generic copy can only be similar to the original protein.

Because biosimilars aren’t identical copies, “biotech and big pharma are looking to squash the movement by throwing bioequivalent issues and quality-control issues,” says Mary Ann Crandall, an independent pharmaceutical analyst at research firm Kalorama Information. “I think that will continue to hinder things. These products are too much of a cash cow to just let generics come in and cannibalize it.”

World-wide sales of all biological drugs reached $130 billion in 2009, according to research firm IMS Health, and are expected to grow much faster than conventional chemical drugs.

Another factor keeping the biosimilars market in check is the lack of clear regulatory guidelines.

While the European Medicines Agency has so far approved 13 simpler biosimilar drugs such as insulin, final guidelines for complex biosimilars are still pending. Analysts say they may be introduced next year.

In the U.S., regulators are currently working to establish how intensive testing for biosimilars needs to be and how the traditional three-phase drug-approval process for originals can be abbreviated. A key concern is to make sure that biosimilar drugs are safe and effective.

“I had predicted that it would be in place by 2009 but now, although there has been progress, there are still numerous regulatory hurdles. Big pharma is very influential and not about to go quietly,” Ms. Crandall says.

Roche, which has already prepared for generics competition but expects the impact from biosimilars on Rituxan to be limited, says that while it supports the development of regulatory frameworks for biosimilars, patient safety is of the utmost importance.

“Specific processes, data, research and experience are needed to ensure that a biosimilar monoclonal antibody has the same profile, efficacy and safety as the originator product,” Roche says.

This may prove too difficult for many players. Michael Frizberg, vice-president of Lonza Generics, said that developing a complex biosimilar can take up to eight years and cost more than $100 million.

Sandoz’s head, Jeff George, put the cost as high as $250 million for difficult-to-copy large-molecule drugs.

Although small U.S. biotech Spectrum Pharmaceutical, which has teamed up with Viropro Inc., says it has enough funds to develop a copy of Roche’s Rituxan—financial constraints may keep many smaller firms from entering the market. “It may cost too much time and money for a number of small to midsized generics manufacturers to embark on biosimilars production,” says Stephane Dutu, asset manager at Vernes & Associés in Geneva.

“Furthermore,” Mr. Dutu says, “doctors may be reluctant to use biosimilars as it is a new class of products with no track record in terms of safety and benefits.” A poll conducted in summer 2010 by GMS Dr. Jung GmbH, Gesellschaft für Markt- und Sozialforschung, found that more than 50% of physicians in Germany have heard or read little or nothing about biosimilars.