IHF Community Corner

Dr. Eigen reviews questions from the community about everything related to medical debt and medical bills and provides feedback based on his expertise as a physician leader. If you have a question that you would like Dr. Eigen to address, please submit the question through this email: info@indianahealthfund.org

For this month’s blog, Dr. Eigen has prepared a response to answer a question from the community:

Question from the Community:

Cost of  branded prescriptions vs. generic prescriptions

Dr. Eigen’s Response:

The widely used maintenance prescription inhaler FLOVENT is being discontinued in January, and it will be replaced with an authorized generic — a medicine that is the same as Flovent but without the branding.

The manufacturer, GlaxoSmithKline (GSK), is discontinuing production of Flovent HFA and Flovent Diskus. The authorized generics will be manufactured by GSK and distributed by Prasco LLC.

The change isn’t likely to mean a difference in treatment for most patients, as the generic has the same formulation.

While the stated price of the drug is lower than the branded drug that price reduction is not necessarily passed on to the consumer. The price of the branded drug, Flovent has risen nearly 50% since 2014. Much of this increase has been borne by third party payer’s insurance or Medicaid. Despite the media touting that the price will go down some insurance programs do not cover generics to the same extent as branded drugs, and some do not cover them at all. So, they may still not cover the drug in the generic form. That could mean that while the stated price goes down the patient will be responsible for the entire cost of the drug, thus increasing the out-of-pocket cost to the patient.

People who use Flovent may wish to call their doctors and insurance companies to get more information. It may be that the doctor can change you to a similar drug that has a lower out of pocket cost.

The key price that should be considered by the patient is the out-of-pocket charge not the stated price.

I had a recent personal experience with this. I was in Florida and needed some eye medication. I went to the local CVS and was quoted a price of $745 for a 30-day supply. This same medicine had cost me $147 at my pharmacy in Indianapolis. So, the stated price was very different from the out-of-pocket expense. It is important to remember that there is no “price” for a medication. The insurance company will determine what you pay out of pocket.

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