November 10, 2011

Fresh Hope That Lipitor and Azilect Won't Push Me Into the "Donut Hole" In 2012

I  recently paid about $500 for a 90-day supply of Azilect, the prescription drug used by most people with Parkinson's. Because I had fallen into Medicare's so-called "donut hole" earlier this year, I wondered what I might do to avoid -- or at least delay -- falling into that same hole next year.

The Donut Hole for 2012
Most Medicare prescription drug plans have a dollar limit on what they cover for prescription drugs. Once you and your drug plan have spent a certain amount of money for covered drugs, you have to pay all out-of-pocket costs up to a yearly limit, after which Medicare's catastrophic coverage kicks in. This coverage gap is the dreaded, infamous "donut hole." But you needn't pay all the costs while you're in the hole. Your plan will cover at least 7% of generic  drug costs. You also receive a 50% discount on covered name brand drugs, while the manufacturer covers the other 50%.

The entry point for the donut hole varies from plan to plan, but this year it was $2840. In 2012, it will increase to $2930. Last year, the donut hole ended and Medicare's catastrophic coverage took over at $455O in annual drug costs. Next year it will be $4700. So, the donut hole for 2012 will run from $2930 to $4700.

Azilect and Lipitor: My High-Cost Drugs
Last year, two drugs were primarily responsible for pushing me into the donut hole:

Azilect. This Parkinson's drug slows the breakdown of dopamine in the brain, and is usually prescribed along with L-DOPA (Sinemet). I take 1mg once a day. Unfortunately, there's no generic for Azilect and – boy! --is it expensive. A 90-day supply costs $938.14, a price that my AARP medical insurance plan indicates it negotiated down from the retail price of $988.28. A nine-month supply of this would cost about $2930, the 2012 starting price for the donut hole.

Lipitor. I’ve been taking Lipitor for years, and it has done an excellent job lowering my cholesterol. When I started taking the drug, my total cholesterol was over 300. At my annual physical this spring, it was 151. My report indicated: "Your HDL, the desirable component, is really outstanding at 61."

With comments like that, I've stuck with Lipitor, even though it’s much more expensive than the generic zocor, another statin used to treat cholesterol. Both Lipitor and zocor are equally effective in treating cholesterol, but most people can take half the amount of Lipitor for the same effect.

Lipitor is the highest selling drug of all time and, with no generic available, it is high priced, bringing in $10.7 billion last year for its manufacturer -- Pfizer, Inc. Its retail price, according to my AARP drug plan, is $398.12, which they negotiated down to $376.78

Latest News on Generic for Lipitor: This Just In!
For years, we've been hearing reports that a generic for Lipitor would soon be available. Then… nothing happens. I decided to check on this issue today before publishing this post and found that Bloomberg News is reporting today that the Indian pharmaceutical company Ranbaxy Laboratories Ltd. (which holds the rights to be the first marketer of a Lipitor generic) is on the verge of ending its three-year dispute with our Food and Drug Administration, and might be able to begin marketing its product by the end of this month. Ranbaxy reportedly may sell its “version” of Lipitor at a 55% discount. Pfizer is said to be considering bringing out a non-prescription version of Lipitor to offset the expected sales hit on its powerhouse profit maker.

It's a complicated story. For the full Bloomberg report, see http://buswk.co/swH221.  http://buswk.co/swH221.

An hour or so later, Bloomberg has a breaking news report that Teva Pharmaceuticals was going to join Ranbaxy in marketing the generic.

Relief from Azilect's High Cost May Also Be Coming in 2012
Even if a generic Lipitor is available next year, Azilect alone would still push me into the donut hole. But relief may be on its way here as well.

There is now no generic Azilect (rasagline mesylate) product available. But the patent for Azilect expires in February, 2012, and several drug companies are likely to begin manufacturing a generic version of the drug.

I’m hopeful, since the Azilect patent expires early next year. But the Lipitor patent expired three years ago, and we’re still waiting.

If a generic does not come on market next year, I may try a cost-saving gambit that a member of my Parkinson's support group uses. He has regularly scheduled appointments with his neurologist three times a year. At each meeting with his doctor, he requests – and receives -- a free sample of Azilect. The samples that manufacturers supply to doctors typically have a month's worth of pills.

On-Line Canadian Pharmacies
Dealing with online Canadian pharmacies is risky, since many of them are scams. In fact, the one that often comes up near the top of the list when you Google "canadian online pharmacies" is alleged to be run by a Russian mafia.

Earlier this year, I did some web searching and found a good site: http://www.healthpricer.com/.

This website searches for the best costs on prescription meds. The first time I tried it on Azilect, I got a price of $570 from a company in Grenada that got good reviews. Later when I checked again, it gave a price of $525 from a Canadian company, Maple Leaf Meds, that gets even better reviews. Its website is www.healthpricer.com

I planned on checking this out a couple months ago, but the car crash distracted me.

In any event, fingers crossed on both Azilect and Lipitor generics for 2011.

2 comments:

GrandmaElvis said...

    I have already received a notification from Insurance Company (I do my meds by mail order in 90 day supplies)
that the generic for Lipitor will be available for all refills as of November 30th. 
 

John said...

That's great.  This confirms it's finally going to happen. Did they tell you the new price?

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