CHAPEL HILL, N.C. - The generic copay waiver program supplements BCBSNC's Medication Dedication program, launched in January 2008 which waives copays for generics for selected chronic conditions. Thus far, Medication Dedication has saved customers more than $13 million in out-of-pocket expenses.
"We don't want folks to have to choose between paying for prescriptions and paying their bills," says Ron Smith, PharmD, BCBSNC vice president of employer health and corporate pharmacy. "We're facing tough times with this recession. To help our customers with costs and help them stick with their prescription regimens, we're reviving our generic copay waiver program. Based on data, we know these programs help people improve their health and control costs."
The 2009 generic copay waiver program applies to about 1 million BCBSNC customers, including:
- Blue Advantage customers (once they meet their annual prescription deductible, if applicable).
- Medicare Supplement customers who have prescription coverage on their policies (once they meet their annual prescription deductible, if applicable).
- Many customers who receive coverage with Blue Cross and Blue Shield of North Carolina from their employers.
- Members of self-funded employer groups are eligible only if their employer group has pharmacy benefits through BCBSNC and has chosen to participate in the program.
The savings for an individual who takes advantage of the generic copay waiver could be significant for the first half of 2009. For example, if a BCBSNC customer takes three brand name medications per month with a copay of $30 each, that person spends $90. If that customer can shift to generic medication, she would save $540 from January through June 2009.
To take advantage of the program, eligible BCBSNC members who are prescribed a covered generic drug simply take the prescription along with their BCBSNC ID card to a participating pharmacy. Pharmacies will automatically apply the copay waiver to eligible members filling generic prescriptions. Drugs used for cosmetic purposes and medications that are also available over-the-counter are not covered by this program.
In 2004, BCBSNC launched a generic copay waiver program and saw an immediate increase in generic prescription usage. This is important because generic drugs are equivalent to corresponding brand name drugs in active ingredients, dosage, strength, safety and performance, but they cost a fraction of their brand name counterparts. Since prescription drug costs are a key driver of rising medical costs, the long-term increased use of generics also impacts future premiums for the benefit of our customers.
With or without the copay waiver, generic medications cost less out-of-pocket than brand-name medications. Generic copay waiver programs increase those savings and highlight the benefits of generic medications.
Since 2004, BCBSNC has waived copayments for generics on three additional occasions, each time helping customers to save out-of-pocket prescription costs by moving from brand-name prescription drugs to generics. During a generic copay waiver period in 2006, BCBSNC customers saved more than $50 million in out-of-pocket prescription costs. Utilization of generic drugs rose from 51 to 58 percent during 2006, and has increased to more than 66 percent in 2008, through the use of continued generic promotional efforts, such as the Medication Dedication program.
In January 2008, BCBSNC launched its Medication Dedication program, which helps encourage BCBSNC members with congestive heart failure, high blood pressure, high cholesterol and diabetes - all conditions that require regular medication - to stay on their medications. The Medication Dedication program waives copays for certain generic medications that treat these four targeted conditions and will run through 2009. To date, results from the Medication Dedication program include the following:
- BCBSNC customers have saved more than $13 million in out-of-pocket prescription drug costs in 2008 through the Medication Dedication program.
- Approximately 12 percent of members who used brand-name medications prior to the program have switched to generics.
- BCBSNC data shows a 10 percent increase in members filling their initial prescription as a generic medication.
- BCBSNC customers eligible for the Medication Dedication program are filling prescriptions sooner following their initial diagnosis and filling them more often than they were prior to the program's implementation.
Other Medication Dedication initiatives include launching outbound medication reminder calls to members about the importance of taking their medication and launching adherence messages to providers via electronic prescribing devices. Additional Medication Dedication initiatives will launch in 2009.
About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.7 million members, including approximately 896,000 served on behalf of other Blue Plans. For 75 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at bcbsnc.com.