CardiologyMD is correct on this arduous and tireless debate on generic Vascepa being written by a any type of doctor and how it works at the pharmacy. I've been in the Pharma Industry 29 years and I've dealt with this type of situation numerous of times. In fact I'm dealing with it right now with 2 of our drugs. Although a generic is only indicated for one specific use or has only one indication if there are other uses by this molecule that are FDA approved using the brand and is still under patent it does not matter. The doctors prescribes the brand for the second indication with good intent but if the generic is on the manage care formulary of the patient it will alert the pharmacist in the system there is a bio equivalent and to substitute the generic for the brand. Indications are not written or part of a prescription by the doctors. Now if the doctor checks the box Dispensed as written or Brand necessary on the Prescription the brand has a much better chance of getting filled at the pharmacy. This will require in most cases the doctor or someone in his office to fill out what they call a PA (Prior Authorization). Basically meaning a lot of extra time and paperwork to submit. Then the Manage Care reviews the doctor's PA to see if it's a valid request and then determines should it be approved or not. PA's are approved quite a bit by manage care plans. The challenge is getting the doctor and his office to do the extra steps to get the brand approved. Also if the manage care plan approved the PA it normally will cost the patient a SIGNIFICANTLY amount of more money. Where the generic V is a Tier 1 Co-Pay for a plan costing the patient $10-20 for the Rx vs the PA approved brand could cost the patient anywhere from $100-300. The amount will vary by plan based on the drug and the contract, if they have one with the Manage Care Plan. This is a very complicated and complex situation this board has been debating now for many weeks. Please trust me on this one. I live this scenario everyday and for the past several years. There is no easy answer to solving this problem. Finally on the topic of sueing a doctor, pharmacy, pharmacist or even a manage care company for substituting an approved generic for a brand with one or more indications where the generic is approved for only the first indication, " It Ain't Gonna Happen". You can't sue every doc, pharmacy or manage care plan. Not feasibly possible. The only possible law suit to be brought into this type of situation would be if a Generic Company actually started promoting the approved generic for the second indication of the brand where the generic is not indicated for. Once again "This Ain't Gonna Happen" for many reasons. One is because generic do not promote products they sell them. Two they are not gonna risk anything for something they are already benefiting from and getting.
I hope this ends the long and hard fought battle many of you have been fighting against one another.
I can't wait to finally retire so I do not have to keep fighting this brand vs generic battle in my career. I live, eat, drink and dream about it everyday unfortunately. Take care everyone.
AI
