Medication Choices
Reducing Pharmacy Spend
Brand-name drugs have a significant impact on overall pharmacy spending. In 2020, the Association for Accessible Medications reported that while brand-name drugs were only 10% of prescriptions filled, they accounted for 80% of prescription drug spend. *
When a brand-name drug becomes generic, a conversion takes place automatically at the pharmacy. But what about patients taking a brand-name drug without a generic equivalent available?
Patients have improved adherence when their medications are affordable. To support your patients, you may consider prescribing a lower-cost alternative such as a generic or brand-name drug within the same therapeutic drug class. While this requires a new prescription, it allows your patient to access a medication that is as safe and effective at a lower cost, which may reduce their out-of-pocket expense.
The list below provides examples of the most frequently prescribed brand-name drugs with lower-cost alternatives.
= generic, Tier 1 or Tier 0; 
= Preferred BRAND, Tier 2; 
= Non-Preferred BRAND, Tier 3 or excluded
| Drug Class | High Cost Drugs | Lower Cost Drug** | Estimated Cost Savings*** [based on claims data] |
|---|---|---|---|
| ADHD | VYVANSE (lisdexamfetamine) | ADDERALL XR (dextroamphet/amphetamine) |
~84% |
| Asthma | DULERA (mometasone/formoterol) | ADVAIR DISKUS (fluticasone/salmeterol)‡ | <1% |
| SYMBICORT (budesonide/formoterol) | <1% | ||
| BREO ELLIPTA (fluticasone/vilanterol) | <1% | ||
| ASMANEX HFA (mometasone) | QVAR REDIHALER (beclomethasone)‡‡ | <1% | |
| FLOVENT HFA (fluticasone)‡‡‡ | <1% | ||
| Birth Control | LO LOESTRIN FE (norethindrone/ethinyl estradiol) | generic LOESTRIN 24 FE “JUNEL 24 FE” (norethindrone/ethinyl estradiol) | ~71% |
| generic LOESTRIN 1/20 “JUNEL 1/20” (norethindrone/ethinyl estradiol) | ~90% | ||
| Diabetes (Insulin) | TRESIBA (insulin degludec) | BASAGLAR (insulin glargine) | ~49% |
| LEVEMIR (insulin determir) | ~40% | ||
| NOVOLOG (insulin aspart) | NOVOLIN-R (insulin regular) | ~59% | |
| FIASP (insulin aspart) | |||
| Diabetes (Non-Insulin) | FORTAMET (metformin ER OSM) | generic GLUCOPHAGE (metformin) | >99% |
| GLUMETZA (metformin ER OSM) | generic GLUCOPHAGE XR (metformin ER) | ||
| N/A | generic GLUCOTROL (glipizide) | N/A | |
| N/A | generic ACTOS (pioglitazone) | N/A | |
| JANUVIA (sitagliptin) | generic NESINA (alogliptin)‡‡ | ~65% | |
| INVOKANA (canagliflozin) | FARXIGA (dapagliflozin)‡‡‡ | ~5% | |
| JARDIANCE (empagliflozin) | ~2% | ||
| VICTOZA (liraglutide) | TRULICITY (dulaglutide) | ~2-6% | |
| BYDUREON (exenatide) | OZEMPIC (semaglutide) | ~2-6% | |
| Mood | TRINTELLIX (vortioxetine) | generic LEXAPRO (escitalopram) | >99% |
| generic PROZAC (fluoxetine) | >99% | ||
| generic ZOLOFT (sertraline) | >99% | ||
| LATUDA (lurasidone) | generic LAMICTAL IR (lamotrigine) | >99% | |
| REXULTI (brexpiprazole) | generic SEROQUEL IR (quetiapine) | >99% | |
| generic ZYPREXA (olanzapine) | >99% |
** Switching from a BRAND to generic will also reduce the patient’s medication copay
*** Estimated % cost savings based on CareFirst claims data of bolded reference product Jan-Sept 2022
Disclaimer: Provided in support of drug cost transparency and informational purposes only; not a request for therapeutic interchange
‡ BRAND products available at a Tier 1 copay
‡‡ Available on Exchange Formulary only; may require Prior Authorization with Commercial Formulary
‡‡‡ Available on Commercial Formularies only; may require Prior Authorization with Exchange Formulary
Updated: January 2023, subject to change