Discussions that mention duragesic

Pain Management board

We're getting into some "advanced" stuff here......


The pharmacist did a little investigating. Watson was the most expensive and not w/i whatever formula the pharmacy uses to calculate their minimum profit for a medication.

As I've posted before, the way it works is this....When a particular pharmacy submits a claim to insurance, they are reimbursed back to the "average" of the meds in it's class. When they stock meds below the average wholesale cost, they make more money. When they stock meds which have a price above the average wholesale cost, they don't make as much. This is why most pharmacies typically stock the cheapest meds in each class or category. This insurance formula is implemented by the insurance industry and applies to the chains as well as the independents. My pharmacist said that he has a number of situations where they actually "lose" money because his cost on a particular med is way above "average wholesale." He said the patch is a perfect example...Because the Mylan and Sandoz are so cheap, the average wholesale cost is much lower than Watson, so if he stocks Watson, he actually loses money for dispensing. He said there are a # of situations like this with many meds.

However, the big chains have a lot of buying power, thus, they can cut their own deals with the drug companies. Thus, their profit margins get even bigger because they have even cheaper acquisition costs...But they are still reimbursed back to "averge" wholesale, which is an industry standard. So, if a big chain can cut a good deal on say Watson patches, then it makes sense for them to stock them, but other pharmacies won't, thus, you can't find them.

[QUOTE]Also, Ex, if you happen to jump in here - you have mentioned many times that your dr. said "not to even *call*" if you got Mylan fentanyl patches b/c there were so many problems. Did your doctor ever say what he/she thought the problems were? I've looked at a lot of the threads about the difference between patch brands and I haven't really gotten a clear sense of the specific problems with Mylan. If you could summarize what you know, I would be grateful.

Yes, that is correct in what my Doc said. I asked the same question and he said it's because the active ingredient med, glue, and by products are all mixed up in one mass and stuck on a patch. Therefore, the actual med distribution is very uneven....Due to the other stuff being mixed with it. Additionally, I think it also has to do with the 20% rule and Mylan just puts 20% less in it. Obviously, Docs aren't going to go around and tell you that because it would create a firestorm. Most patients don't have the ability to understand the Hatch-Waxman Act of 1999.

Sandoz is made by Janssen, who makes Duragesic....Same factory. However, they use less of the active ingredient because they are allowed to....More profit for them, and it protects the brand to an extent. I've tried both Sandoz and Duragesic and not only is Duragesic much more powerful, it has much better glue. The generics cut cost where ever they can, and I don't blame them. Same situation, just different industry.

When I was working, I worked for a fortune 5 manufacturing company. The company is known for good quality American made branded products. However, we also made quite frequently, "off brands." I can say without a doubt, we made those "off brand" products with much less quality. Would they work...yes. Would they work well....Probably. But, they weren't up to the quality of the branded product.

[QUOTE]One more question while we're at it - Anthem still lists LA oxycodone as a generic. Can they claim that there is actually generic LA oxycodone still out there? I thought it was all gone at this point. It makes a difference for some policies since some policies require you to pay the difference in cost between the generic and brand if the generic is available.

There is some lag time between what you see and what they see. Your particular area may be "out" of generic, but there is still some in the pipeline in other areas of the country and because Anthem is nationwide, they must be consistent. Plus, it works in their advantage because the policy holder is "penalized" by getting brand even though generic isn't available in some places....More money for Anthem....Think about it.

Hope this helps.