Today, almost all carriers of Individual family plan medical insurance, including a high deductible health plan, are adding a rather large separate deductible for brand name drugs. Even health insurance premiums that are expensive because of a low deductible are still requiring a separate deductible for brand name drugs. The deductible is different from carrier to carrier, but the average is around $500.
A senior health plan like Medicare Advantage or a Part D prescription plan may also have separate deductibles to meet for prescription coverage. The name brand drugs themselves have a pretty hefty price tag. With BlueCross/Blue Shield of Florida some name brand drugs have a $90 copayment. Remember that the price you pay for the drug, plus what the carrier pays for the drug, all goes to the total amount when figuring the donut hole. For 2011 once you and your drug plan together have paid over $2840 you will pay 93% of the negotiated drug cost for generics and 50% for brand name drugs until your out-of-pocket costs plus amount of drug manufacturer’s discounts reach $4550.
Are generic drugs as effective as the brand name drugs? Here’s what the FDA says: “Generic drugs are important options that allow greater access to health care for all Americans. They are copies of brand-name drugs and are the same as those brand
Name drugs in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use.” The FDA went on to add “All generic drugs approved by the FDA have the same high quality, strength, purity and stability as
Brand-name drugs. And, the generic manufacturing, packaging, and testing sites must pass the same quality standards as those of brand name drugs.” Jacqueline Kosecoff, CEO of Prescription Solutions, part of UnitedHealth Group, was quoted in Fortune magazine as saying “Many Americans erroneously believe that the most expensive drug is always the most effective drug.” Ms. Kosecoff also stated that “consumers enrolled in drug plans typically save $20-60 per prescription by switching to a generic drug.”
Are you wondering how a drug gets to be a generic? Me too! The original drug manufacturer’s patent has to expire. The manufacturer usually gets 20 years for a patent but usually applies for the patent when they are in the development phase. Only after the FDA has approved a drug can they sell it. Once the twenty year patent runs out other companies can make “generic” versions of the drug.