Psycho-Babble Medication Thread 66343

Shown: posts 1 to 12 of 12. This is the beginning of the thread.

 

Generic Prozac Availibility

Posted by fachad on June 13, 2001, at 15:22:51

Does anyone know when generic fluoxetine will be available?

I know the Prozac patent expires sometime in August, but when will the generic tabs actually be in pharmacies across the U.S., ready to fill prescriptions?

Also, will my pdoc have to do a new prescription with substitution permissible for the pharmacy to fill with generic?

 

Re: Generic Prozac Availibility » fachad

Posted by Sunnely on June 16, 2001, at 1:27:08

In reply to Generic Prozac Availibility, posted by fachad on June 13, 2001, at 15:22:51

Hi Fachad,

Don't know for sure but I believe Barr Labs, the first Prozac generic manufacturer is ready to ship them out as soon as Lilly's stronghold patent on Prozac expires, August 2001.

Barr Labs has the exclusive rights for the first 6 months to manufacture generic Prozac. Incidentally, Barr Labs is the same company that sued Lilly regarding manufacturing generic Prozac couple of years ago. Lilly paid them off, I believe $4 million, to shut up. Hence, Lilly's patent on Prozac was extended.

****************************

> Does anyone know when generic fluoxetine will be available?
>
> I know the Prozac patent expires sometime in August, but when will the generic tabs actually be in pharmacies across the U.S., ready to fill prescriptions?
>
> Also, will my pdoc have to do a new prescription with substitution permissible for the pharmacy to fill with generic?

 

Re: Generic Prozac Availibility » fachad

Posted by Sunnely on June 16, 2001, at 1:31:36

In reply to Generic Prozac Availibility, posted by fachad on June 13, 2001, at 15:22:51

Once generic Prozac becomes available, pharmacists are allowed to substitute from brand name Prozac to generic Prozac, unless a specific instruction from your doctor, "Dispensed As Written," is indicated in the script.

****************************************

> Also, will my pdoc have to do a new prescription with substitution permissible for the pharmacy to fill with generic?

 

Re: Generic Prozac Availibility » Sunnely

Posted by Jane D on June 16, 2001, at 16:51:08

In reply to Re: Generic Prozac Availibility » fachad, posted by Sunnely on June 16, 2001, at 1:31:36

> Once generic Prozac becomes available, pharmacists are allowed to substitute from brand name Prozac to generic Prozac, unless a specific instruction from your doctor, "Dispensed As Written," is indicated in the script.

Sunnely - What about refills to existing prescriptions? They would not have been marked DAW because it was irrelevant at the time. Will they just automatically be refilled with name brand Prozac?

Jane

 

Re: Generic Prozac Availibility

Posted by Phil on June 16, 2001, at 18:07:40

In reply to Re: Generic Prozac Availibility » Sunnely, posted by Jane D on June 16, 2001, at 16:51:08

Just get your doc to call in a new script for the generic.

 

Re: Generic Prozac Availibility » Jane D

Posted by Sunnely on June 16, 2001, at 18:31:53

In reply to Re: Generic Prozac Availibility » Sunnely, posted by Jane D on June 16, 2001, at 16:51:08

Hi Jane,

If you are covered by health insurance, I believe this too could be switched to generic Prozac by the pharmacists, unless a DAW is written by your doctor in the script. Of course, the issue of generic Prozac becomes moot if you are paying for your own prescription and prefers to continue with the more expensive brand name, Prozac. May be Cam can clarify this since this falls in his domain.

************************

> > Once generic Prozac becomes available, pharmacists are allowed to substitute from brand name Prozac to generic Prozac, unless a specific instruction from your doctor, "Dispensed As Written," is indicated in the script.
>
> Sunnely - What about refills to existing prescriptions? They would not have been marked DAW because it was irrelevant at the time. Will they just automatically be refilled with name brand Prozac?
>
> Jane

 

Re: Generic Prozac Availibility

Posted by Phil on June 16, 2001, at 18:54:38

In reply to Re: Generic Prozac Availibility » Jane D, posted by Sunnely on June 16, 2001, at 18:31:53

Jane...When I managed a drug store for a large chain, the % of generics sold was kept track of. The more the better. You should not have a problem. Just have the doc call in another script if the pharmacy won't give you the generic.
Sometimes when my bank account is dwindling, I ask my doc to call in Clonazepam even though I have refills left on Klonopin. No big deal.

Phil

 

Re: Generic Prozac Availibility

Posted by Jane D on June 16, 2001, at 19:11:16

In reply to Re: Generic Prozac Availibility, posted by Phil on June 16, 2001, at 18:54:38

> Jane...When I managed a drug store for a large chain, the % of generics sold was kept track of. The more the better. You should not have a problem. Just have the doc call in another script if the pharmacy won't give you the generic.
> Sometimes when my bank account is dwindling, I ask my doc to call in Clonazepam even though I have refills left on Klonopin. No big deal.
>
> Phil

Phil & Sunnely,
Thanks. I'm just curious about how these things work. Even though I have insurance I will be trying the generic. I feel I owe it to Lilly after all the shenanigans they pulled to delay the marketing of the generic.

Another question. Is it true that the drugstores make more off the generics? And, if it is true, do they still make more with the managed care contracts?
Jane


 

Re: I'll be quiet now

Posted by Phil on June 16, 2001, at 19:14:33

In reply to Re: Generic Prozac Availibility, posted by Phil on June 16, 2001, at 18:54:38

Once the generic is on the market, if you want the brand, you can 'sometimes' save money by asking your doc to be sure to check dispense as written. Some insurance companies will charge you a larger co-pay for the brand if it's at your request and not the doctors.

This is the kind of question, a good one, that drives some pharmacists NUTS. Pharmacist, by and large, are really caring people and want to consult w/ patients and get to know them, etc.
Unfortunately, they spend huge amounts of time trying to explain to patients why the patients insurance company is screwing them and their store isn't!!

Phil

 

Re: Our responses are overlapping : )

Posted by Phil on June 16, 2001, at 19:23:09

In reply to Re: Generic Prozac Availibility, posted by Jane D on June 16, 2001, at 19:11:16

Jane, I'm not sure about the managed care deal but like I said earlier, the higher the percentage of generics sold over brand, the
more 'the powers that be' smiled. And we do want those fine people to smile.
What makes bidness(Texas terminology)people smile...ONLY MONEY!!!!!!!

Phil

 

Re: Generic Prozac Availibility » fachad

Posted by Cam W. on June 16, 2001, at 22:28:28

In reply to Generic Prozac Availibility, posted by fachad on June 13, 2001, at 15:22:51

Fachad - My experience in Canada, particularily Alberta, is that when generics were introduced about 9 or 10 years ago, third party payers (Social Services, Seniors Benefits, Native Affairs, etc.) all switched to a formulary system. This meant that the third party payer would only pay for the "lowest cost alternative" of a drug; or, in essence, they would only pay for the lowest priced generic form of the drug. Surprizingly, all generic companies ended up having the same lower price.

If a patient wanted the brand name, they would have to pay the difference out of their pocket. This could mean a difference of $50 to $60 a month for a prescription of Zantac™ (ranitidine) or, more common to this board, $15 to $20 a month for Prozac™ (fluoxetine).

Also, many of these third party payers put a cap on the number of days worth of a medication that a patient could obtain. Subscribers to these plans could only get a maximum of 31 days of psychoactive medication (eg antidepressants, antipsychotics, anxiolytics), but 100 days of most heart meds. One of the silly rules was that Social Services would only allow 31 days of haloperidol (a relatively safe typical antipsychotic) but would allow 100 days of benztropine (Cogentin™ generic, an anticholinergic side effects medication used for EPS) which one can overdose on and can cause hallucinations. Sometimes the ivory tower boys (and girls) just don't think. I have never seen any responsible doc write for 100 days of benztropine.

Another problem with formularies is that if a doc writes for a drug not on the formulary, then the drug was not paid for by the third party payer. Therefore, if a new drug was released between April and October (when the new formulary came out), it would not be covered until the next April or October. They have fast tracked this system now, and if a drug is significantly different (read better) from others then they would allow the new drug to be dispensed by special authorization (eg Effexor) or by sending an update sheet to the pharmacies (eg Seroquel). Whether a drug gets fast tracked depends on the skill of that drug's marketing people.

As for substitution to generic, this can be (and was) done automatically, when the new formulary went into effect. We really had no problems and there was little resistance to the change, especially for those who could not afford to pay the difference. There were several generic drug companies so, after a few months, we got to know which were the more reliable and equivalent to brand name drugs. Doctors, at first did write "No Substitution" (had to be in the doctor's handwriting to be honored), but the patient would have to pay the difference. The pharmacist would have to phone the doc and get him to change the prescription if the patient wouldn't or couldn't pay the difference. Nine years later, nearly everyone uses generic.

Really, few drugs were not interchangeable. The one's that I had problems with were a particular brand of salbutamol (Ventolin™ generic) inhaler and a certain generice brand of timolol (Timoptic™ generic) eye drops. The one generic salbutamol inhaler didn't seem to work as well and the generic timolol eye drops caused allergic reactions in some people. Also, generic Valium™ (diazepam) was not wanted by many drug abusers and dealers because they did not bring as high a price on the street.

The brand name companies did not lower their prices in Canada (which would seem the obvious thing to do) because if they lowered their prices here, they would have to do so in other countries, especially the U.S. To get around this, several of the brand name companies formed their own generic companies and sold what were called "ultra-generics". These were exactly the same drug as the brand name, but with different markings on the tablet or capsule. Actually, when making, say alprazolam, the same batch was used to make Xanax™ and the generic equivalent, Alti-Alprazolam. Only the stamp was different. Ya gotta like how big business thinks < sarcasm >.

A little long winded - Cam

 

Re: Thanks Cam...np

Posted by Phil on June 17, 2001, at 8:59:09

In reply to Re: Generic Prozac Availibility » fachad, posted by Cam W. on June 16, 2001, at 22:28:28

> Fachad - My experience in Canada, particularily Alberta, is that when generics were introduced about 9 or 10 years ago, third party payers (Social Services, Seniors Benefits, Native Affairs, etc.) all switched to a formulary system. This meant that the third party payer would only pay for the "lowest cost alternative" of a drug; or, in essence, they would only pay for the lowest priced generic form of the drug. Surprizingly, all generic companies ended up having the same lower price.
>
> If a patient wanted the brand name, they would have to pay the difference out of their pocket. This could mean a difference of $50 to $60 a month for a prescription of Zantac™ (ranitidine) or, more common to this board, $15 to $20 a month for Prozac™ (fluoxetine).
>
> Also, many of these third party payers put a cap on the number of days worth of a medication that a patient could obtain. Subscribers to these plans could only get a maximum of 31 days of psychoactive medication (eg antidepressants, antipsychotics, anxiolytics), but 100 days of most heart meds. One of the silly rules was that Social Services would only allow 31 days of haloperidol (a relatively safe typical antipsychotic) but would allow 100 days of benztropine (Cogentin™ generic, an anticholinergic side effects medication used for EPS) which one can overdose on and can cause hallucinations. Sometimes the ivory tower boys (and girls) just don't think. I have never seen any responsible doc write for 100 days of benztropine.
>
> Another problem with formularies is that if a doc writes for a drug not on the formulary, then the drug was not paid for by the third party payer. Therefore, if a new drug was released between April and October (when the new formulary came out), it would not be covered until the next April or October. They have fast tracked this system now, and if a drug is significantly different (read better) from others then they would allow the new drug to be dispensed by special authorization (eg Effexor) or by sending an update sheet to the pharmacies (eg Seroquel). Whether a drug gets fast tracked depends on the skill of that drug's marketing people.
>
> As for substitution to generic, this can be (and was) done automatically, when the new formulary went into effect. We really had no problems and there was little resistance to the change, especially for those who could not afford to pay the difference. There were several generic drug companies so, after a few months, we got to know which were the more reliable and equivalent to brand name drugs. Doctors, at first did write "No Substitution" (had to be in the doctor's handwriting to be honored), but the patient would have to pay the difference. The pharmacist would have to phone the doc and get him to change the prescription if the patient wouldn't or couldn't pay the difference. Nine years later, nearly everyone uses generic.
>
> Really, few drugs were not interchangeable. The one's that I had problems with were a particular brand of salbutamol (Ventolin™ generic) inhaler and a certain generice brand of timolol (Timoptic™ generic) eye drops. The one generic salbutamol inhaler didn't seem to work as well and the generic timolol eye drops caused allergic reactions in some people. Also, generic Valium™ (diazepam) was not wanted by many drug abusers and dealers because they did not bring as high a price on the street.
>
> The brand name companies did not lower their prices in Canada (which would seem the obvious thing to do) because if they lowered their prices here, they would have to do so in other countries, especially the U.S. To get around this, several of the brand name companies formed their own generic companies and sold what were called "ultra-generics". These were exactly the same drug as the brand name, but with different markings on the tablet or capsule. Actually, when making, say alprazolam, the same batch was used to make Xanax™ and the generic equivalent, Alti-Alprazolam. Only the stamp was different. Ya gotta like how big business thinks < sarcasm >.
>
> A little long winded - Cam
>
>


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