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Case Study #1: Push Back on Generics
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• Spiraling Out-of-Pocket Brand Rx Prices, 50% of Americans on Rx
• Groundswell of Criticism re: Generics Efficacy
• AARP Rx Pricewatch (2005-2009); Retail Brand Rx Prices & Co-pays increased 46% ( +10% CAGR)
• New York Times reported on Oct 1, 2013 additional 43% increase in co-pays offered through Affordable Care
Act Healthcare Exchanges
• 2005-2013 Rx Co-pay Compounded Increase = 108%
• OUT OF POCKET COSTS RISING FASTER THAN TOTAL COST OF CARE
• Post Inflation (Real) U.S. Median Income 2005-2009 shrunk by 2.2%
• Median Brand Rx Price = $115/Prescription, w/$40 Co-pay vs. Generic $21/Rx, w/$5 Co-pay
• Brands’ Co-Pay Coupons Buried in Websites, Dr.’s Offices; Tons of Discovery Friction
• Price Induced Shifts: Generics = 82% of Volume, 27% of Sales; Brands = 18% of Volume, 73% of Sales
• Medicine Adherence Shrinks to 50% after 6 months, driving up escalated healthcare costs (emeregency room
vists, surgeries, etc…) by $290Billion per year (source: http://www.nehi.net/news/press_releases/110/nehi_
• FDA Definition of Bio-equivalent: “A generic's maximum concentration of active ingredient in the blood must not
fall more than 20% below or 25% above that of the brand name.”
• This means a potential range of 45%; yet generics labeled same as branded
• Negative Health Outcomes associated w/ Overly Broad 45% Range include:
• Cmax and Tmax/Blood Absorption Rates and Bio-availability go unreported, unenforced by FDA
• Unpredictable Swings in Experienced Drug Metabolism (For the first time in its history [Oct 2012], FDA
withdrew previously approved generic [Wellbutrin] due to failure to meet already loose tolerances; 5 other
cases pending. (Source http://management.fortune.cnn.com/2013/01/10/generic-drugs-quality/ )
• Previously Unreported Side Effects (Nausea, Vomiting, Endocrine function disruption, etc.)
• Synopsis: The FDA approved 45% range on active ingredients used in generics can be illustrated by way of
example. In attempts to save money;
1) a buyer opts for 20% watered down store brand paint rather than the more expensive premium brand
name, and later discovers that the purchased product runs, streaks, requires multiple coatings (multiple
gallon purchases) and still doesn't have the aesthetics or quality of the premium brand. Outcome:
Buyer seeks refund.
2) a buyer purchases store brand cake mix that, relative to the premium brand, has 20% less baking
powder, yeast, and a heavier grade flour, the combination of which causes the baked cake to not rise
and lack desired fluffiness. Outcome: Buyer throws out cake.
• Among the points of these two examples is that watered down paint or cake that doesn't rise won't kill you,
but low grade medicine can harm you, and yet some take more care in selecting paint or cake mix than they
do in choosing generics over the original safe formularies of branded Rx...
• Lack of Foreign Generic Manufacturing Controls Underscore Safety Concerns
RxCoup’s Transparent Discovery + Crowdsourcing = Access to Affordable Medicines
• 1-Click: Actionable “Bite Size” Data Empowers Consumer
• Point-of Decision: Frictionless Discovery/Acquisition @ Points of Decision (Point of Care + POS)
• Relevance: 1-Click, Optimal Choice of Multiple Personalized Offers
• Immediacy: Opens Targeted Couponing to Larger Demographics
• Savings: Up to70% Discounts w/ 1 Touch !
• Gamification: Scaled Discounts for Interacting w/ Adherence Notifications to Share Health Condition Insights (Rx
Response, Side Effects) + Coupons in online Community
• Bottom Line: Value = Savings + Quality (Obtain Safe Brand Formulary @ Net Price near Generic)