Effects on the Cost and Utilization of Proton Pump Inhibitors From Adding Over-the Counter Omeprazole to Drug Benefit Coverage in a State Employee Health Plan

Consumer Choice Between Common Generic and Brand Medicines in a Country with a Small Generic Market

“…10,11 Occasionally, switching to OTC medicines has been shown to reduce overall costs for patients and health plans (e.g., omeprazole). 12 We list some relevant health-related arguments to study OTC medicine use in the general public. The use of OTC medicines is not without concern; for example, one of the most common medicines worldwide, acetaminophen (often called paracetamol outside of the United States), is responsible for 57% of acute liver failures in the United Kingdom.…”

“…[14][15][16][17] Health care practitioners are in the position to make consumers more aware of and increase knowledge about generics and medicines in general. 4,12,18 Consumer acceptance of generic medicines was shown to be a prerequisite for acceptance of generic substitution (that is, the pharmacist switches from a brand prescription to the delivery of a generic medicine). Some might consider generic substitution the ultimate way for increasing generic medicine use and containing pharmaceutical expenditures.…”

A 30-Month Evaluation of the Effects on the Cost and Utilization of Proton Pump Inhibitors From Adding Omeprazole OTC to Drug Benefit Coverage in a State Employee Health Plan

“…The purpose of this larger dispensing fee was to ensure that switching beneficiaries from an Rx to OTC product would be at least revenue-neutral and perhaps revenue-favorable for the pharmacy provider. 7 With the $13 dispensing fee, the dollar gross margin for omeprazole OTC would be similar to the other PPIs. The higher dispensing fee was also perceived as helping to compensate pharmacists for the extra work in switching patients, which involved calling prescribers to obtain an Rx for omeprazole OTC but thereby avoided the need for a physician office visit.…”

“…Although several appeals were submitted, none met the criteria and were therefore denied. 7 At this time, a diagnosis of ZE or other hypersecretory condition is no longer accepted as the basis for appeal since all PPI drugs are still available to each member, at a higher copay.…”

“…7 This initial projection was based on the original benefit design that included OTC coverage but not coverage of generic omeprazole Rx. However, because of the shortage of omeprazole OTC, the benefit design was later modified, effective October 1, 2004, to include coverage of both omeprazole OTC and generic omeprazole Rx.…”