The cholesterol-lowering drug Lipitor goes generic tomorrow, but you won’t save a lot of money switching to it, at least for now. And even if it could help you save money, it's important to know that Lipitor is often not the best first choice for people who need to lower their LDL (bad) cholesterol.
While generic drugs usually cost less than brand-name versions, Lipitor is an exception to the rule for the next six months or so, for two reasons. First, only one or two drug makers will produce the generic form of the drug, atorvastatin, between now and May 2012, essentially cornering the market and keeping the price relatively high. Second, Pfizer, the maker of Lipitor, has reportedly negotiated lower prices for the drug with several large insurance companies and pharmacy benefit managers. As a result, the generic and brand-name versions will cost about the same.
But there is another way to save on cholesterol-lowering medication: Use one of the related drugs that are just as effective as Lipitor for most people, and often cheaper, too. Here’s our advice when that makes sense and, when it doesn’t, whether you’re better off with generic atorvastatin or the brand-name version, Lipitor.
Which statin is right for you?
We recommend Lipitor or generic atorvastatin only if you need to lower your LDL by 30 percent or more and have a history of either heart attack or acute coronary syndrome. In those situations, the drug clearly helps prevent heart attacks and cuts the risk of premature death.
But we recommend different statins in other circumstances. Specifically, we recommend:
• Generic lovastatin or pravastatin if you need to need to lower your LDL by less than 30 percent. Those drugs are just as effective as their brand-name versions (Altoprev and Mevacor for lovastatin, and Pravachol for pravastatin), but cost less.
• Generic simvastatin if you have heart disease or diabetes, or if you've had a heart attack or have acute coronary syndrome but your LDL level is not highly elevated. It works as well as its brand-name counterpart, Zocor, but is less expensive.
In those cases, the drugs listed above are as safe and effective as Lipitor or generic atorvastatin, and often cheaper. Indeed, you can buy a 30-day supply of all three for just $4 through various discount generic drug plans at major chain drugstores across the country, including Target and Walmart.
Lipitor or generic atorvastatin?
If you do need Lipitor, or are already taking it and want to stay on it, here’s our advice:
• If you have major, private drug coverage, from companies such as UnitedHealth or Medco, you’ll likely have a lower co-pay for Lipitor than for generic atorvastatin until May 2012, according to multiple news reports. Indeed, your new co-pay for Lipitor might actually be lower than what you now pay. And you might be able to reduce you co-pay further by using the manufacturer discount program for Lipitor, which is slated to run until December 2012. (The program is not available if you live in Massachusetts; if you have Medicare or Medicaid or another federal or state health plan; if you have a state-sponsored discount pharmacy card; or if your own private insurance covers your drug costs in full. Also, not all pharmacies accept the coupons. So you might have to shop around or order the drug directly from Pfizer.) Note that even if your doctor writes you a prescription for generic atorvastatin, for now, some insurers might require that your pharmacist fill it with the brand-name version instead.
• If you have Medicare Part D, which covers drug costs, it appears that some carriers have made similar deals with Pfizer on lower co-pays for Lipitor. For example, Cigna RX1 is reducing its co-pay from $31 in 2011 to $3 in 2012, CVS Caremark Value is going from $42 to $8, and WellCare Classic from $41 to $6. On the other hand, First Health Part D Premier appears to be dropping Lipitor from its formulary entirely. You can find out whether your plan is changing its coverage by going to Medicare.gov and click on “Compare Drug and Health Plans” which allows you to search for coverage details based on your zip code. Or contact your State Health Insurance Assistance Program (SHIP), which offers free information and free counseling about Medicare.
• If you pay for drugs out of pocket, generic atorvastatin might be somewhat less expensive than the brand-name version, but not by much. After May 2012, more generic drug companies will be able to manufacture the drug, which should help lower the price somewhat. In the meantime, Pfizer offers other discount programs that include Lipitor and might be worth checking out. Details and qualification rules vary. Read the fine print.
Plan would delay sales of generic for Lipitor [New York Times]
Pfizer aims for Lipitor deal with Express Scripts [Bloomberg News]
UnitedHealth chooses Lipitor over generics [Bloomberg News]
Pfizer’s latest twist on pay for delay [ProPublica]