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A Quick Guide for Plan Sponsors
The Generic Incentive Program is designed to assist plans in
What drug products does NPS recommend for targets?
increasing their generic utilization rates by combining the Generic
Two or more drugs are considered therapeutical y equivalent if they
Utilization Program and Therapeutic Interchange Program. In many
can be expected to produce identical levels of clinical effectiveness
cases, and with the prescribing physician’s approval, the Therapeutic
and sound medical outcomes in patients. Plans may customize this list
Interchange Program substitutes one single source brand-name
by adding to it or taking products away. Some plans have chosen to
product for another single source brand-name product or a generic
utilize this program to also encourage members who are taking multi-
equivalent, when available. The Generic Incentive Program adds an
source brand-name medications that have a direct generic available to
additional dimension to these programs to increase the motivation for
switch to the generic. NPS recommends the fol owing drug categories
a member to switch to a therapeutical y equivalent generic by offering
for inclusion in the Generic Incentive Program.
Over the next five years the availability of
Potential Targets for the Generic Incentive Program
generic drugs wil be increasing. Many drugs that
are on a plan’s top twenty-five drug utilization list
(for depression, aniexty or other conditions)
by either number of prescriptions or total dol ars in
Celexa®, Lexapro®, Paxil CR®, Paxil®, Prozac Weekly®,
drug spend wil be coming off patent. A program
such as the Generic Incentive Program can be a
(to treat pain and inflammation)
great tool to enhance a plan’s current Intervention
etodolac, ibuprofen, naproxen or nabumetone
Program especial y on medications that members
(to treat or suppress herpes simplex virus)
take on a routine or maintenance basis. On average
(to treat thyroid conditions)
Levoxyl®, Synthroid®, Levothroid®, Unithroid®
can be realized for every single source brand-name
(cholesterol lowering agents)
prescription that can be switched to a generic.
Mevacor®, Zocor®, Pravachol®, Lescol®, Lescol XL®
How does the program work?
PROTON PUMP INHIBITORS
Aciphex®, Prilosec®, Nexium®, Protonix®,
With the Generic Incentive Program, plan sponsors
Prilosec OTC™, omeprazole OTC, omeprazole
waive the co-payment for the generic product for a
specific number of months if the member switches
Clarinex®, Clarinex D®, Zyrtec®, Zyrtec D®, Allegra®, Allegra D®
to a therapeutical y equivalent generic product.
(for heart or high blood pressure conditions)
lisinopril, benazepril, enalapril, moexipril
The average generic co-payment for a plan is
Rhinocort®, Nasonex®, Nasacort AQ®, Beconase AQ®
JODFOUJWF PG PGGFSJOH NFNCFST DPQBZNFOU
*Generic alternatives may not be the exact equivalent of a listed medication, however can be used for similar health conditions.
for a specified number of months when moving
**When generic is available in the marketplace.
from a targeted brand-name drug to a generic
NPS also recommends tablet splitting opportunities be utilized when available and appropriate to maximize plan savings on generic
can be an excel ent way to motivate the member to switch. Additional y, the return on investment for a plan to waive
What support and communication strategies are available?
the co-payment for a specified number of months is very positive and
NPS will assist plans who wish to implement the Generic Incentive
rewarding to both the plan and the member. Members then receive
Program with targeted member communication letters. NPS will
the continued benefit of paying the plan’s regular generic co-payment
identify the candidates and provide a letter to the member that
(versus the brand they were previously paying) for refil s after the
incentive time frame has expired. (See example)
t QSPHSBNEFTDSJQUJPOJODMVEJOHBOOPVODFNFOUPGUIFDPQBZJG the member moves to a generic within a specified time frame
for a plan that offers the Generic Incentive Program for three months of co-pay waiver
Plan Savings Per Month for
Plan Savings Per Month for
First Three Months
Next Three Months
about generics and about whether this change is appropriate
Savings per month . $78.83
Savings per month .$78.83
given their medical history and/or medical conditions
generic co-pay waiver . 7.00Net plan savings per month .$71.83
Savings over first three months .$215.49
Savings over next three months .$236.49
Savings possibility over 6 months = $451.98
800 546 5677
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Tradenames are the registered trademarks of the respective product manufacturers.
Marginal voices in the media coverage of controversial health interventions: how do they contribute to the public understanding of science? M. Hivon, P. Lehoux, J.-L. Denis and M. Rock 2010 19: 34 originally published online 21 January 2009The online version of this article can be found at: can be found at: Public Understanding of Science Additional services and information for
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