Over the past several years, prescription drug costs in workers’ compensation claims have risen dramatically, making it increasingly more important for claims professionals to carefully evaluate this exposure and mitigate costs when possible. Helios Settlement Solutions understands that keeping up to date on new generic formulations is part of an overall strategic approach to reduce the cost of claims and ultimately the prescription portion of the Medicare Set Aside (MSA).
Every brand medication has a patent life that will eventually expire. Once the patent expires, generic equivalents become available to the market at a lower cost. Although there is no set brand-versus-generic price differential upon generic entry into the market, clinical analysis shows that on average the generic has a 10% lower price at time of launch over its brand counterpart.
On December 10, 2014, Teva announced the launch of its generic equivalent to Pfizer’s brand Celebrex® (celecoxib). Celebrex is a non steroid anti-inflammatory medication utilized most often within the workers’ compensation industry for the treatment of ankylosing spondylosis, rheumatoid arthritis, osteoarthritis as well as for the management of acute pain. The generic formulation is available in 50mg, 100mg, 200mg, and 400mg strengths. Brand Celebrex 200 mg capsules have an Average Wholesale Price (AWP) of $8.42 per capsule. Initial AWP of the generic celecoxib 200mg from Teva is $7.58 per capsule. Other companies who were also authorized to release their generics included Actavis, Lupin, Mylan, as well as Pfizer’s generic division, Greenstone.
Per the “Helios 2014 Workers’ Compensation Drug Trend Report” brand Celebrex ranked number five in the top 25 medications of total spend within the workers’ compensation industry, so introduction of the generic formulation will definitely have an impact on both claims costs and MSA allocations. Helios Settlement Solutions realizes the importance of keeping you informed of new generics that become available in an attempt to assist in lowering claim costs. As we enter into 2015, Helios Settlement Solutions will continue to keep the industry informed of prescription updates and changes.