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One Example of Wasteful Spending in Pharmacy Benefit Plans

Sometimes combining two things into one can be a good thing such as hot fudge and ice cream, baseball and hotdogs, or peanut butter and jelly.  Other times, not so much.

A big offender in this second category can be combination drugs.  They are the combination of two inexpensive generic drugs marketed as a new brand drug and as you might guess,one that is more expensive.

An article produced by Sharon Orange in GoodRx “You’re Paying Too Much for These 10 Expensive Combination Drugs,” highlights 10 examples of combination drugs that together are more expensive but when purchased separately are far less expensive and when used together are just as effective.  

One example of a combination drug that many people are aware of is Duexis.  Duexis is a drug used for the treatment of arthritis and is equivalent to taking 800mg of Ibuprofen and 20 mgof Pepcid.  The average cash price according to GoodRx is $3,222.48 for 90 tablets.  At Walmart, GoodRx shows the cost for 90 tablets of 800 mg of Ibuprofen at $17 and 90 tablets of 20 mg Pepcid at $13.46.  The total for both drugs is $30.46 compared to $3,222.48 noted above.

Other combination drugs are:

     -Treximet used for migraines which is equivalent to taking 500 mg of naproxen (Aleve) and 1.5 tablets of 50 mg of sumatriptan.

     -Acanya used for acne which is equivalent to a tube of clindamycin 1% and a 30 gram tube of benzoyl peroxide 2.5%.

     -Ziana also used for acne which is equivalent to mixing 30 grams of clindamycin gel and 45 grams of tretinoin 0.025% gel.

     -Duac and Benzaclin, is similar to Acanya but has generic combinations available (clindamycin / benzoyl peroxide).

     -Loestrin Fe (birth control with iron) includes iron (Ferrous fumarate 75 mg) in some of the pills in the pill packet for days 22 – 28.  You can buy an equivalent over-the-counter iron supplement for these days.

     -Contrave is used for weight loss medication which is equivalent to taking 8 mg of naltrexone (comes in a 50 mg tablet) and 90 mg of bupropion (comes in a 100 mg tablet).

Combination drugs are costly to plan participants and to the plan sponsor.  They may often be included in a plan sponsors Formulary. Combination drugs are but one example of areas where we can help plans ponsors by addressing the use of low value drugs which are wasteful and costly.  Please contact us at 225-927-1940 for more information on how we can help your plan address the adoption of a more waste free formulary to reduce overall costs to the participants and to your plan. More information can be found as well on our website www.cobaltrx.com .