Generic Medication

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PistonFan531 said:
Do you think that generic medication is hurting the business aspect of pharmacy considering that it costs a lot just to fill a prescription?
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You are not reimbursed based upon the price of the prescription. It's a percentage thing actually because the only thing that really changes when filling something is the cost of the prescription. You make a set amount per Rx as it starts with and the difference is mainly the difference between the cost you paid for it and what the insurance or individual pays for it.

Actually you make a lot less off of name brand drugs.

Generally you are paid off of the AWP of the drug, the dispensing fee and whatever taxes may be involved.

Something like Lipitor 40mg may cost you $140 to buy #30, which you are then paid $155 from the insurance or customer for dispensing

Something like Lisinopril 20mg may cost you $0.90 to buy #30, which you are then paid roughly $30 bucks by the insurance or the customer.

So you make $15, or 10%, off the name brand lipitor, but you can make $20 bucks, or 2,000% off of the generic.

Granted there are variations between this and the prices aren't exact, but you get the idea. Generics offer a much larger margin to gain profit than do name brands, namely because there is a sole generic manufactuer for name brand which locks in the cost.

If you really wanna know how we get screwed... well I have a recent blog post for that lol
 
phathead said:
You are not reimbursed based upon the price of the prescription. It's a percentage thing actually because the only thing that really changes when filling something is the cost of the prescription. You make a set amount per Rx as it starts with and the difference is mainly the difference between the cost you paid for it and what the insurance or individual pays for it.

Actually you make a lot less off of name brand drugs.

Generally you are paid off of the AWP of the drug, the dispensing fee and whatever taxes may be involved.

Something like Lipitor 40mg may cost you $140 to buy #30, which you are then paid $155 from the insurance or customer for dispensing

Something like Lisinopril 20mg may cost you $0.90 to buy #30, which you are then paid roughly $30 bucks by the insurance or the customer.

So you make $15, or 10%, off the name brand lipitor, but you can make $20 bucks, or 2,000% off of the generic.

Granted there are variations between this and the prices aren't exact, but you get the idea. Generics offer a much larger margin to gain profit than do name brands, namely because there is a sole generic manufactuer for name brand which locks in the cost.

If you really wanna know how we get screwed... well I have a recent blog post for that lol
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Exactly. My pharmacist told me we don't make any money off of the more expensive name brands. It makes me wonder why we bother, but whatever.
Take a 1000 tablet bottle of hydrochlorothiazide, for instance. We buy them for about $5 each, and we sell 30 tablets to the consumer for $4.
 
phathead said:
You are not reimbursed based upon the price of the prescription. It's a percentage thing actually because the only thing that really changes when filling something is the cost of the prescription. You make a set amount per Rx as it starts with and the difference is mainly the difference between the cost you paid for it and what the insurance or individual pays for it.

Actually you make a lot less off of name brand drugs.

Generally you are paid off of the AWP of the drug, the dispensing fee and whatever taxes may be involved.

Something like Lipitor 40mg may cost you $140 to buy #30, which you are then paid $155 from the insurance or customer for dispensing

Something like Lisinopril 20mg may cost you $0.90 to buy #30, which you are then paid roughly $30 bucks by the insurance or the customer.

So you make $15, or 10%, off the name brand lipitor, but you can make $20 bucks, or 2,000% off of the generic.

Granted there are variations between this and the prices aren't exact, but you get the idea. Generics offer a much larger margin to gain profit than do name brands, namely because there is a sole generic manufactuer for name brand which locks in the cost.

If you really wanna know how we get screwed... well I have a recent blog post for that lol
Click to expand...
I think it is a good business plan to carry both name brand and generics as well. You can tell the customer do you want drug X for $20/pill or drug X' for $2/pill with the same medical results. It makes the customer happy and the management happy when both benefit. The time-limit of patents also encourage drug companies to research new drugs to replace drugs they have that are on the waning side of there patent term. I think generics are a good thing all the way around.
 
joh0472 said:
I think it is a good business plan to carry both name brand and generics as well. You can tell the customer do you want drug X for $20/pill or drug X' for $2/pill with the same medical results. It makes the customer happy and the management happy when both benefit. The time-limit of patents also encourage drug companies to research new drugs to replace drugs they have that are on the waning side of there patent term. I think generics are a good thing all the way around.
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Good theory, but in practice it's 50/50 whether or not the patient will see that logic.
 
Generics? Are you kidding? My patients can only take brand name medications! Especially if it's their Oxycontin or their Xanax, generics just won't do. Nevermind that they'll take generic Lopressor or Glucophage. 🙄

There are the genuine lunatics, however, who won't take ANYTHING if it isn't brand.
 
The psych meds frickin' kill me. Now there is an isomer for venlafaxine....DESvenlafaxine (Pristiq) which allegedly has less side effects. My dept. refuses to order it and we make the patients bring their own to the hospital. It is just too expensive to keep on the shelf. Especially if it outdates!
 
My favorite one is Carbidopa/Levodopa... it's fun to say :laugh:
 
I heard that these genetic drugs don't work the same.
 
DASicari said:
I heard that these genetic drugs don't work the same.
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I did a CE on generic drug laws not too long ago... here's an excerpt straight from my Pharmacy Technician's Letter. My personal opinion is that some people may be sensitive to the differences. However, the far majority who say they can feel a difference only do so because it's in their head.

"First, generics must be identical in strength and dosage form to the brand-name drug. This is called "pharmaceutical equivalence."

Second, generics only get approved by FDA if they show that their average rate and extent of drug absorption in the body is within the statistical range of 80% to 125% of the brand product. This is called "bioequivalence." It's the same standard that is used for different batches of BRANDED drugs. These numbers can be a little misleading...and may still sound like too much variability to a lot of people. But keep in mind that calculating this 80% to 125% range involves complicated statistics. It's NOT the same as saying that drug levels can vary by 20%. In fact, if drug levels vary by more than 10%, the drug will likely fail the bioequivalence studies. In reality, most generics don't vary from brand products by much more than 3% to 4%.

Drugs that are both pharmaceutically equivalent AND bioequivalent are considered "therapeutically equivalent." Drugs that are therapeutically equivalent can be substituted for each other.

Generics can have different inactive ingredients than the brand name or other generics. This does NOT affect drug levels, but a patient may be allergic or intolerant to a specific excipient or additive in a generic or branded drug. Explain to patients that in nearly all cases, the generic equivalent will produce the same therapeutic results as the brand-name drug."
 
It matters with some meds like lamictal and it definitely matters with thyroid, levothroid vs. Levothyroxine for many people.
 
phathead said:
Good theory, but in practice it's 50/50 whether or not the patient will see that logic.
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The funny thing is that the patients think that the doctor's know more about drug interaction than the pharmacists. My best friend is in D.O. school and he said he spent one semester on pharmacology...ONE semester. Unfortunately most Doc's prescribe drugs based on the drug reps that bring them lunch everyday and the generic companies don't spend their money on pens, notepads, clipboards, and other office supplies. I don't think many generic companies hire salesreps who take Dr. out golfing or give them concert tickets.
 
rxlea said:
It matters with some meds like lamictal and it definitely matters with thyroid, levothroid vs. Levothyroxine for many people.
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Yeah, with drugs with a narrow therapeutic range (like warfarin), changing generic brands can cause different results.
 
joh0472 said:
The funny thing is that the patients think that the doctor's know more about drug interaction than the pharmacists. My best friend is in D.O. school and he said he spent one semester on pharmacology...ONE semester. Unfortunately most Doc's prescribe drugs based on the drug reps that bring them lunch everyday and the generic companies don't spend their money on pens, notepads, clipboards, and other office supplies. I don't think many generic companies hire salesreps who take Dr. out golfing or give them concert tickets.
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I have a T-shirt that says, "Your Doctor spent one semester in medical school on drugs, I spent 8."

It's good.
 
joh0472 said:
The funny thing is that the patients think that the doctor's know more about drug interaction than the pharmacists. My best friend is in D.O. school and he said he spent one semester on pharmacology...ONE semester. Unfortunately most Doc's prescribe drugs based on the drug reps that bring them lunch everyday and the generic companies don't spend their money on pens, notepads, clipboards, and other office supplies. I don't think many generic companies hire salesreps who take Dr. out golfing or give them concert tickets.
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The even funnier thing is that doc's will fight you on that knowledge claiming they know more. Gotta love those MD egos lol
 
phathead said:
The even funnier thing is that doc's will fight you on that knowledge claiming they know more. Gotta love those MD egos lol
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I hear the MDs talk to pharmacists all the time like this... "If you wanted to make these calls, you should've gone to medical school."

They're still so clueless at how many interventions pharmacists catch every month, they're a huge safety net for these oblivious practitioners.
 
Passion4Sci said:
I hear the MDs talk to pharmacists all the time like this... "If you wanted to make these calls, you should've gone to medical school."

They're still so clueless at how many interventions pharmacists catch every month, they're a huge safety net for these oblivious practitioners.
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My little boy was given a presciption for an antibiotic for an upper respiratory tract infection. Went to the pharmacy and guess what, the dose was for an adult. Pharmacist caught at first glance of looking at the paper. Didn't even have to type in the info. Pharmacist know their drugs!
 
phathead said:
The even funnier thing is that doc's will fight you on that knowledge claiming they know more. Gotta love those MD egos lol
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I remember a nurse argued with a pharmacist over something a little bit ago. Something about classes of antibiotics and how such and such isn't in the same class.
Sounds like a losing battle to me.
 
Dezixn said:
I remember a nurse argued with a pharmacist over something a little bit ago. Something about classes of antibiotics and how such and such isn't in the same class.
Sounds like a losing battle to me.
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I feel bad for good nurses because for every one good nurse there's about 20 mentally handicapped nurses.

Seriously, what do they teach them in school?
 
phathead said:
I feel bad for good nurses because for every one good nurse there's about 20 mentally handicapped nurses.

Seriously, what do they teach them in school?
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I saw an article in the newspaper about this! It covered some nurse that moved across 3 states and had multiple patients die under her care (from negligence) :scared:
 
phathead said:
I feel bad for good nurses because for every one good nurse there's about 20 mentally handicapped nurses.

Seriously, what do they teach them in school?
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Well, from my inquiry (yes, I've made one), nurses don't learn anything medically related. Instead, they learn about "caring."
 
ArkansasRanger said:
Well, from my inquiry (yes, I've made one), nurses don't learn anything medically related. Instead, they learn about "caring."
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There are many well-educated and competent nurses...and there are many that are subpar. I find that the nurses in critical care areas are the most knowledgeable, but there are definitely nurses I would refuse to let "care" for me LOLOLOL
 
rxlea said:
There are many well-educated and competent nurses...and there are many that are subpar. I find that the nurses in critical care areas are the most knowledgeable, but there are definitely nurses I would refuse to let "care" for me LOLOLOL
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Yeah, I'd have to agree. When I was in paramedic school and rotating through so many specialties I thought critical care nurses seemed the most knowledgeable too. All biases aside, I found that the paramedic/RNs were pretty darn good at their jobs be they CC, EM, or aeromed. Of course, once I got into working as a medic I only interacted with CC and EM people so I never got to judge anyone else afterwards.

Once again, here's hoping that some sap on an admissions committee will give me brownie points for having been a paramedic. :xf: Why, I don't know...just hoping.
 
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