Price Comparison of Commonly Prescribed Pharmaceuticals …

Price Comparison of Commonly Prescribed Pharmaceuticals in Alberta 2014

Price Comparison of Commonly Prescribed Pharmaceuticals in Alberta 2014

What would your patients do with extra cash? Perhaps buy new running shoes and a gym membership, or take a trip to escape the Canadian winter? We could be saving our patients and the health care system substantial money if prescribers chose lower cost (often equivalent) medications, instead of higher cost medications, which may not be covered by provincial drug plans. Choosing sitagliptin (Januvia) over metformin for diabetes, perindopril (Coversyl) over thiazides for hypertension and pregabalin (Lyrica) over amitriptyline (Elavil) for chronic pain can add up quickly.

Physicians have limited knowledge and poor access to information about drug plans.1 With this in mind, we endeavored to create a document listing the price of medications commonly prescribed by Albertan primary care health providers. Although medication choice should be based on clinical situations, many medications are therapeutically interchangeable and using this reference allows prescribers to consider costs when prescribing. Other cost savings methods to be considered include: increasing prescription lengths for long-term medications, using combination products, and pill splitting where possible.

The prices represent the entire retail cost of the prescription filled at a community pharmacy in Alberta, including markup and dispensing fees. This does not reflect what a patient would pay if covered under a drug plan, but rather the cost to an individual without coverage, or the cost to the health care system. Prices have been rounded to the nearest $5. Although prices may differ between wholesalers and pharmacies (especially for oral contraceptives and insulins), this tool allows for relative cost comparisons between medications in the same class or for treating the same disease. This list is not exhaustive and we encourage you to contact your neighborhood pharmacist for information on medications not included that you use in your practice.

This document is up to date as of January 1, 2014. Since the 2013 edition, generic prices have changed substantially, dropping in price in most cases. For 2014, we have added a section on hormone replacement therapy and Alzheimer's disease medications. Please forward any feedback, including prices that surprised you or cases where knowledge of prices made a difference in your practice to nickonchuks@.

Costs listed are primarily for the generic product (with generic name bolded) as provincial drug plans will generally only pay for the lowest cost formulation available. Brand name prices (with brand name bolded) are for products still under patent protection. We also provide information on coverage by Alberta Blue Cross (BC) and Indian Affairs (IA) formularies and which products require Special Authorization (SA).

Michael Kolber BSc, MD, CCFP, MSc Associate Clinical Professor Department of Family Medicine, University of Alberta

Jayson Lee BSc Pharm Clinical Pharmacist, Pharmacare Specialty Pharmacy #2 Edmonton, Alberta

Calculating medication costs

Tony Nickonchuk BSc Pharm CDE APA Manager, Walmart Pharmacy Peace River, Alberta

Medication costs were calculated by adding the wholesale cost of the medication plus mark up dispensing fee. Alberta Health & Wellness determines the maximum markup and dispensing fee that can be charged based on the acquisition cost of the medication and is illustrated in the table below.

This table is accurate for all medications except oral contraceptives, insulins, and injectables, where the total charge can be as high as 2/3 of the acquisition cost to a maximum of $100 per prescription.

Acquisition Cost $0-74.99 $75-149.99 $150+

Dispensing Fee $10.22 $15.53 $20.94

Markup $1.71 $2.00 $5.03

Total Fee $11.93 $17.53 $25.97

Acknowledgements

We wish to thank Stacy Jardine, BSc. Pharm, Jamie Hoy, BSc. Pharm, Mike Allan MD, CCFP and Tina Korownyk MD, CCFP for their contributions to this project.

Reference

1. Allan GM, Lexchin J, Wiebe N. Physician Awareness of Drug Cost: A Systematic Review PLoS Med. 2007 Sep;4(9):e283.

Table of Contents

CARDIOVASCULAR.........................................................................................................................................................5

Lipid Lowering Agents, Beta Blockers, Calcium Channel Blockers.........................................................................................................................5 Angiotensin Converting Enzyme Inhibitors (ACEIs), Angiotensin Receptor Blockers (ARBs), Diuretics................................................6 Anti-platelet, Anti-coagulant..................................................................................................................................................................................................7

HYPOGLYCEMIC AGENTS............................................................................................................................................8 RESPIRATORY.................................................................................................................................................................. 9 SMOKING CESSATION.................................................................................................................................................10 GASTROINTESTINAL..................................................................................................................................................... 11 PSYCHIATRY.................................................................................................................................................................... 12 contraceptives....................................................................................................................................................... 13 HORMONE REPLACEMENT THERAPY.................................................................................................................14 ANALGESICS.................................................................................................................................................................... 15 UROLOGY.......................................................................................................................................................................... 16 Miscellaneous.......................................................................................................................................................... 17

Antibiotics, Osteoporosis, Alzheimer's

Price Comparison of Commonly Prescribed Pharmaceuticals in Alberta 2014 | 5

Generic Name CARDIOVASCULAR

Brand name

Strength

Dosing

90 Day Cost (unless otherwise noted)

Coverage

Lipid Lowering Agents

Atorvastatin

Lipitor

Rosuvastatin

Crestor

Atorvastatin

Lipitor

Rosuvastatin

Crestor

Atorvastatin

Lipitor

Pravastatin

Pravachol

Simvastatin

Zocor

Ezetimibe

Ezetrol

10mg

QD

10mg

QD

20mg

QD

20mg

QD

40mg, 80mg QD

20mg

QD

10mg

QD

10mg

QD

$40 $45 $45 $50 $50 $55 $55 $200

BC / IA covered BC / IA covered BC / IA covered BC / IA covered BC / IA covered BC / IA covered BC / IA covered SA req'd for BC and IA

Beta Blockers Bisoprolol Metoprolol Metoprolol-SR Bisoprolol Atenolol Metoprolol-SR Atenolol

Monocor Lopresor Lopresor SR Monocor Tenormin Lopresor SR Tenormin

5mg

QD

25mg, 50mg BID

100mg

QD

10mg

QD

50mg

QD

200mg

QD

100mg

QD

$20 $25 $25 $25 $25 $35 $35

BC / IA covered BC / IA covered BC / IA covered BC / IA covered BC / IA covered BC / IA covered BC / IA covered

Calcium Channel Blockers

Amlodipine

Norvasc

5mg

QD

$35

BC / IA covered

Diltiazem-T

Tiazac

240mg

QD

$45

BC / IA covered

Amlodipine

Norvasc

10mg

QD

$45

BC / IA covered

Nifedipine

Adalat XL

30mg

QD

$65

BC / IA covered

LEGEND:

BC = Alberta Blue Cross, IA = Indian Affairs, NC = Not covered, SA = special authorization, SR = sustained release, OTC = over the counter, SQ = subcutaneous injection. SS=Social Services

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download