A nonprofit independent licensee of the BlueCross BlueShield Association
Creating Savings
with Generic Medications
Over the past several years, Excellus BlueCross BlueShield has
actively pursued a number of initiatives that have helped to increase
the use of generic medications. Our overall “generic fill rate” increased
from 37 percent in 1999 to nearly 69 percent at the end of 2009*.
This outcome is substantial. For every one point increase in generic
fill rate, overall drug costs may be reduced by up to two percent.
Across our book of business, that one point increase could translate
into more than $17 million in savings.
Member Education and Outreach
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We use targeted, direct-to-member communications to notify members about safe, effective
opportunities to use a generic in place of the
expensive brand and to help them understand
the savings.
- We send messages specifically targeted to
members who could save by switching from
a brand-name drug to a generic.
- Up to 22 percent of the members who receive
informational mailings voluntarily switch from
their brand-name medication to a cost-saving
generic. The result: Plan sponsors save an
average of $110 to $120 for each 30-day generic
prescription filled - and members save by lowering their out-of-pocket cost.
- Physicians report an increase in patient requests for
generics and lower-cost alternatives following our
targeted member mailings.
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Blue on demand Web tools
- Our Web site, www.excellusbcbs.com, has a Generic
Savings Calculator that demonstrates how much can
be saved when choosing a generic over a brand. For
example, a 30-day supply of Zocor, a popular brandname cholesterol medication, has a retail price of
approximately $164, compared with an average cost
of under $6 for a 30-day supply of simvastatin, its
generic equivalent.
- The Medication Search feature allows members to
search our formularies for generic and lower-cost
alternatives to branded medications.
- Helpful Member Information and brochures can be
viewed and downloaded online.
- The Ask the Pharmacist feature provides members
with an opportunity to e-mail a question about
medications to one of our clinical pharmacists.
Popular questions and answers are posted to
the website.
* Based on drug utilization data from FLRx that provides pharmacy benefit
management services for more than 1 million people in upstate New York
Excellus BlueCross BlueShield “Generic Fill Rate”
Physician Education and Outreach
Employer Group Education and Outreach
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We issue Physician Tip Sheets to keep doctors
and clinical staff informed of generic prescribing
opportunities, providing information on ways to
safely and effectively use generic medications in
place of clinically equivalent expensive brands.
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Through employer and employee communications,
we promote the use of cost-effective generics. In
addition to sending targeted mailings, we regularly
produce customized employee messages for
employer groups.
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We provide Prescribing Profiles and Dispensing
Summaries to all participating physicians. Profiles are
produced quarterly and physicians receive an annual
summary. These reports show the physician’s actual
generic prescribing rate compared to his/her peers
and the targeted performance for the specialty in
key drug classes. This information helps physicians
identify opportunities to increase their generic
prescribing rates.
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We provide Employer Reports to help companies
monitor their generic use rate.
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Through benefit design consultation and program
recommendations, our collaborative efforts help
employers reach their generic fill targets.
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Our dedicated Pharmacy Services Consultants
work with employer groups to provide employee
education and support. For example, pharmacy
services consultants conduct “lunch and learn”
sessions for employees, providing information on
generic alternatives and cost-saving programs.
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“Rx Facts for Employers” is a free newsletter that
highlights cost-saving initiatives with a focus on
generic opportunities.
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Cost saving tools are available on our Web site for
employer groups to download and use.
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We publish Rx Facts, a free, clinical newsletter. The
“New Drug Approvals” column includes updates
on the release of new generic drugs.
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As part of the e-prescribing community, we provide
benefit, formulary and medication history access to
authorized physicians. Electronic prescribing is a safe,
efficient and cost-effective technology that improves
member safety, reduces costs and eliminates wasteful
paperwork.
E-prescribing provides real-time, member-specific
information, allowing physicians to prescribe the most
medically appropriate and cost-effective medication at
the point of care before prescriptions are electronically
transmitted to the pharmacy.
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Our clinical pharmacists are regularly invited to speak to
physician associations and community organizations on
the topic of generic drug use.
Our Generics are Real
campaign raises awareness
about the benefits of generic
drugs. Since its launch in 2005
the GFR increased nearly 16
points, saving approximately $260 million for plan
sponsors and $86 million for members.
Clinical Programs
We work closely with physicians in our community
to encourage more generic prescriptions where
appropriate.
Our programs promote the use of clinically sound
generics and cost-effective therapeutic alternatives
in several drug classes. In targeted classes we
recommend the generic as first line therapy and
the lower-cost brand as second line therapy. This
strategy helps manage the rising cost of prescription
drugs and lower members out-of-pocket prescription
drug expenses.
Our Generic Trial Program gives our members their
first prescription of selected generic medications
at no cost. The free trial provides members with an
opportunity to save hundreds of dollars per year
in out-of-pocket prescription costs if they continue
with the generic medication. The program offers
generic trials in several frequently prescribed drug
classes: high blood pressure, high cholesterol,
heartburn and depression. Nearly 13,000 new generic
trial prescription are written each month representing
B-1949/4393-10FLRx
significant savings. Members save tens of thousands
through waived and reduced copays and plan sponsors
save approximately $100 per generic prescription filled.
The Generic Advantage Program encourages value when
selecting prescription drugs. If members purchase a brand
name medication when there is a generic equivalent
available, they pay additional costs.
Future Savings
Excellus BlueCross BlueShield continues to further increase
generic fill rates through new and expanded initiatives.
Generics have unique value. They provide an opportunity
to lower overall cost to our members and our employer
groups while maintaining access to quality medications
with proven safety and effectiveness.
Excellus BlueCross BlueShield is committed to providing
members, employers, physicians and pharmacists with the
tools and resources they need to maximize the savings
available through the increased use of generic drugs. It’s
another way we bring value to the customers we serve
every day.