Clinical matters: Zocor

by: Anne Boland Docimo, MD

As Merck & Co.’s multi-billion-dollar seller Zocor fades from the scene, one report suggested that the availability of a generic version of this drug will result in annual savings of at least $1 billion.

In June 2006, the Food & Drug Administration approved the first generic version of Zocor, creating significant savings for the many patients who use statins to reduce their LDL cholesterol. The FDA said that in 2005 Americans spent $16 billion on all statins, with Zocor being the second-most-prescribed brand.

Many UPMC Health Plan members already are reaping the rewards of the new generic versions through lower copayments.

UPMC Health Plan’s drug copayments vary by employer group. Here’s one example of copayments for our three-tier formulary plan: $10/$20/$40. That means the generic simvastatin now costs members in this plan $10 for each 30-day supply.

Please consider the following when you prescribe statins:

• Pennsylvania law requires a mandatory substitution of an FDA-approved generic equivalent when one is available, so prescriptions for Zocor are automatically filled with simvastatin.
• If you write “brand-name required” on Zocor prescriptions, your patients will pay full retail price for the brand-name drug.
• If you have patients who take a statin that does not have a generic equivalent, you may want to consider writing a new prescription for Zocor, thus allowing the patient to receive simvastatin at the pharmacy. The total cost of brand-name statins can be four times more than generic statins.
• Simvastatin, like its brand equivalent, is considered a “superstatin” for its ability to reduce LDL cholesterol by nearly half, while also increasing HDL cholesterol.

Unfortunately, some patients may still equate the word “generic” with a substandard product. That, of course, is not true with pharmaceutical products. Here are a few talking points you may want to use when discussing any switch to generic drugs:

• Generic drugs have the same safety and quality as their brand-name counterparts.
• Generic drugs have the same active ingredients as brand-name medications. Only the dyes and fillers are different.
• Not all drugs have generic equivalents. The drug developer has the exclusive right to make the drug for up to 20 years.
• The FDA regulates generic drug manufacturers just like it regulates the makers of brand-name medications.
• To gain FDA approval, the maker of a generic drug must prove that its product’s active ingredients, drug strength, and dosage form are identical to those of the corresponding brand-name drug.
• Generic drugs cost less because the generic drug manufacturer does not have research and development costs and does not have a large sales force or advertising costs.

Zocor is only one opportunity for members to cut costs. Other brand-name drugs that recently became available in generic form include Mobic (arthritis aid), Pravachol (cholesterol), Proscar (shrinks prostate), Zithromax (antibiotic), Zofran (relieves nausea), and Zoloft (antidepressant).

Dr. Docimo is UPMC Health Plan’s chief medical officer.