Jomama If you Rx V and add “dispense as written” the pharmacist will fill the prescription for V. If the submission to the insurance comes back as denied and recommends generic then (if the Pt won’t pay the difference) we use whichever generic we carry. There are 10 different generics for every drug and we can’t carry them all so the pharmacies pick 1 primary supplier. So for example for generics we carry 100 different Dr Reddy versions of brand drugs because the Dr Reddy rep convinced the owner/management that if we carry primarily his brand then we will get a x% cash discount each quarter. This is where the big generics have bargaining power. The contract could specifically state gV has to be our primary version of V to get the discount. You sometimes carry a backup generic because a couple pts have a distinct preference for a particular generic and that is allowed within the Dr Reddy contract but you couldn’t have a significant amount of sales of a competing generic to get your discount. For this reason Amarin would probably team up with Teva or some other generic to ensure they can compete with contracts.
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