Revisiting generics

Buprenorphine Post
entjwb
Posts: 180

Postby entjwb » Mon Feb 13, 2017 10:01 am

I help my patients look on Good Rx app for best price in the area. I also give them different discount coupons for them to try. I have found Good Rx very helpful.
I also try to get them on the program from manufacturer for free med for one year. I am hopefull the injectable Bup will be reasonably priced.

MChaplin
Posts: 183

Postby MChaplin » Mon Feb 13, 2017 10:01 am

In my community prices are a moving target. When my patients have to self pay we call around to several pharmacies and ask them what the best priced option is. Laborious but sometimes can find a better price..

jmosby1469
Posts: 104

Postby jmosby1469 » Mon Feb 13, 2017 10:01 am

It may not fit, I realize, but I'm trying to squeeze into this discussion my recent dilemma in trying to find a more affordable option among several alternative buprenorphine/naloxone formulations, for my older patients without drug coverage benefits in their Medicare policies. It would appear that there's little difference in price among the following 5 options: buprenorphine/naloxone tablets, bunavail, zubslov, Suboxone 8/2 at 24 mg/day, and Suboxone 12/3 at 24 mg/day.****uming the use of the Suboxone discount coupon where applicable, is one of these options more affordable than the others? I realize this will vary among different pharmacies but, in general, which is the most affordable recommendation for these uncovered patients? I'll place this query into a different thread if so advised.

Jeremy K
Posts: 109

Postby Jeremy K » Mon Feb 13, 2017 10:01 am

Thanks all for your answers.

entjwb
Posts: 180

Postby entjwb » Mon Feb 13, 2017 10:01 am

I have some patients who prefer the tablets. Until about 6 months ago there were no problems. Now there is one pill that is giving problems with dissolving speed. Two factors important in sublingual tablets are: grade of lactose for filler and the hardness of compression. Patients say the tablets most pharmacies carry take 30+ minutes to dissolve. This can be a problem with many patients. We are experiencing the same trend in Ohio. I am telling my patients who have a problem to call customer service at the insurance company and if they want the state insurance commission. They may be more effective for change than we will be.

fishdoc
Posts: 111

Postby fishdoc » Mon Feb 13, 2017 10:01 am

Ohio Medicaid CareSource has done the same thing. In those patients I have had on generic tablets at a methadone clinic, none were happy with it. Each new batch was an adventure as the dosage could vary from 80 to 125% blood levels compared to name brand. Patients did exhibit both withdrawal and feelings of mild overdoes. It was impossible to reduce (taper) dosage for these patients as they did not receive a constant dose. I have had similar experiences with the few private patients I have had on generic tablets. The only ones happy with it were suspected of diversion. Diversion was confirmed many times with UDS.

I honestly have no answer what do with patients starting March 1, when the new CareSource policy kicks in.


mattkeene
Posts: 32

Postby mattkeene » Mon Feb 13, 2017 10:01 am

Generics and Suboxone Film have a much higher street value than Bunavail, and are diverted with frequency. However, with the exception of Tennessee, most states don't seem to care and simply look for the least expensive option (not realizing that they likely would save $ by providing less divertable products). With that said, it would appear that more recently, the generics in my locale have begun to "childproof" their versions by placing them in rigid clam-shells and not loosely packaged.


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