C

all it a one-two punch.

At the same time California Governor Jerry Brown signed a law requiring drug makers explain and justify price hikes, he also signed another law prohibiting the use of prescription drug coupons when a lower-priced medicine is available.

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  • I kept waiting for this article to address the most important detail of this bill – what is considered an “alternative”? If there is a generic version of the molecule available, that’s a no-brainer. However if you are Rx’d a brand name antihypertensive for which no generic of that specific molecule exists, does the law mandate you can’t use a co-pay coupon since you could be taking a generic of a different antihypertensive in the same class (like a beta blocker for instance). If that’s the case, I think this bill is ill-advised.
    Another example – what if a patient is Rx’d an extended release version of a molecule which is only available as a brand, however there is an immediate release version of that molecule available as a generic. No co-pay coupon? If that’s the case, again I think this is not a good idea.
    As usual, the details matter.

    • Hi TW,

      Thanks for the note and you ask a good question. The law does not get into the level of detail as you frame it, but does say a coupon cannot be used for a drug if a another that therapeutically equivalent to, or interchangeable
      is available. To use your example, extended release and immediate release drugs work differently and therefore are prescribed for different reasons and are not generally considered interchangeable.

      On the other hand, if one is prescribed a drug and another in the same class is lower cost, then a coupon could not be used. The law says that a coupon cannot be used “if a lower-cost brand name or nonbrand name prescription drug is available that is designated by the United States Food and Drug Administration as therapeutically equivalent to, or interchangeable with” the drug to be prescribed.

      I included a link to the law in the story, so you can read the language. In any event, I hope this helps.

      Regards,
      ed at pharmalot

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