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Generic Anti-Cholesterol Drugs Save $126 Million for Plan Sponsors, Patients

Shift to Generics Biggest in History for America's Most Used Drug Class

ST. LOUIS, February 12, 2007 /PRNewswire-FirstCall/ -- Generic anti-cholesterol drugs helped pharmacy benefit manager Express Scripts save $126 million for its plan sponsors and patients in 2006.

The cholesterol fighting drug Zocor(R) became available as generic simvastatin on June 23, 2006. By that time, Express Scripts had already succeeded in giving its clients and patients a big head start on saving money with this new generic alternative.

As always, clinical considerations were considered first as Express Scripts helped its clients by developing a formulary that preferred generics and Zocor(R), thereby better positioning patients to make the transition to simvastatin. At the end of 2006, 40 percent of all anti-cholesterol drug prescriptions at Express Scripts were for generic simvastatin, lovastatin and pravastatin, up from 8 percent at the beginning of 2006.

Express Scripts' 2006 formulary also preferred the lower-cost brands Crestor(R) and Vytorin(R) in order to provide an appropriate clinical alternative for the minority of patients requiring a more potent anti- cholesterol drug than simvastatin. In 2006, utilization of Crestor(R) among Express Scripts' clients increased from 6 percent of all anti-cholesterol prescriptions to 11 percent. Vytorin(R) utilization increased from 9 percent to 14 percent.

Such a dramatic increase in the generic fill rate within this therapy class had never been achieved prior to 2006. Express Scripts continues to be a leader in promoting greater use of generic drugs, with 59.7 percent of all prescriptions filled with a generic drug.

"The June release of simvastatin led to an historic opportunity," said Express Scripts Chief Medical Officer Dr. Steve Miller. "It is now possible to treat up to 85 percent of cholesterol patients at a much lower cost with a safe and effective generic drug."

"The fact that our pharmacy costs have actually decreased is due to our members' understanding that generic alternatives cost them less, but can work just as well as other medications," explains Commonwealth of Massachusetts Group Insurance Commission (GIC) Executive Director Dolores L. Mitchell. "We have worked closely with Express Scripts to communicate successfully to our members the advantages of generic medications. In 2006, we increased the use of generic anti-cholesterol drugs from 6.6 percent to 57.5 percent. Our overall generic fill rate is currently at 67 percent."

Express Scripts' client Blue Cross of Northeastern Pennsylvania (BCNEPA), which serves 600,000 people, increased their generic anti-cholesterol share from 4 percent to 52 percent. "We've found that most physicians understand and support generics as a clinically sound way for patients to save money," said Director of Pharmacy Management Frank Koronkiewicz, R.Ph.

Since Carolina Care began working with Express Scripts in 2002, its overall generic fill rate has increased from 30 percent to 61 percent. "We strongly believe that greater use of generic drugs helps Carolina Care serve the employers of South Carolina," says Vice President of Operations and Medical Affairs Belinda Cox.

Another Express Scripts client, ConnectiCare, reports simvastatin share moved from 10 percent to 44 percent in 2006. Director of Pharmacy Jeff Casberg MS, R.Ph., says, "There has been little resistance in conversion from doctors and member cost savings have been great, which leads to a win-win for the two most important elements in this process."

DAKOTACARE has seen the trend in generic fill rates rise from 56 percent in early 2005 to over 65 percent in the fourth quarter of 2006. DAKOTACARE Medical Director W. O. Rossing, MD notes, "The anti-cholesterol category has been a particularly strong driver in this initiative with the generic anti- cholesterol utilization increasing from 3 percent to 38 percent in 2006."

Benefits consultant, Rose and Kiernan, Inc. saved their labor union clients $284,000 in 2006 as a result of formulary changes that took advantage of a new generic anti-cholesterol medication. "Managing the formulary is the key to increasing generic fill rate and generic fill rate is the key to cost control," states Rose and Kiernan Vice President Joseph Rogerson. "We were able to provide our labor union clients with substantial savings as a result of a ten-fold increase in our anti-cholesterol generic fill rate."

The key to the success of Express Scripts clients' generic anti- cholesterol drug savings in 2006 was the ability to actively educate and empower patients. For example, letters were mailed to 1.3 million patients alerting them to lower-cost anti-cholesterol drugs on their formulary. Included with each patient letter was a note from the Express Scripts chief medical officer, which the patient could give to his or her physician, outlining lower-cost anti-cholesterol alternatives.

Express Scripts touched patients at other key moments such as the 273,000 times the company reached out to patients when their prescriptions arrived in the company's home delivery pharmacy. Our early results indicated patients chose to convert to preferred products through our home delivery pharmacy at a rate twice that of retail pharmacies. The home delivery pharmacy is a powerful and proven place for securing greater use of generics.

The company's website also made cost comparisons available to patients and its patient care advocates were equipped to discuss formulary alternatives with patients. As a result, thousands of patients were well-equipped to discuss with their doctors the opportunity to take advantage of lower-cost generic versions of their anti-cholesterol drug when clinically appropriate.

"With approximately $50 billion of brand drugs scheduled to go generic over the next five years, we have a tremendous opportunity to continue to deliver substantial savings to our clients by increasing the use of less expensive generic drugs," notes Miller.

Express Scripts, Inc. is one of the largest pharmacy benefit management (PBM) companies in North America, providing PBM services to over 55 million patients through facilities in 13 states and Canada. Express Scripts serves thousands of client groups, including managed-care organizations, insurance carriers, third-party administrators, employers and union-sponsored benefit plans. Express Scripts is headquartered in St. Louis, Missouri. More information can be found at

    Media Contact:

     Rita Holmes-Bobo


CONTACT: Media: Rita Holmes-Bobo of Express Scripts, Inc.,+1-314-702-7584,

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Posted: February 2007