Requiring Mandatory Use of Generics

Historically, physicians have been reticent to prescribe generic drugs for several reasons. A major reason was the concern that generic drugs were not manufactured to the same quality specifications that trade-name products were. Another reason was that trade-name manufacturers send detailing drug representatives into the doctor’s offices to discuss the trade-name drugs one-on-one with the physician while generic drug manufacturers do not do this. The drug “reps” usually give samples of their medications (among other things) to the physician and so physicians tend to want to use those particular medications.

Another reason physicians write their prescriptions for trade-name drugs is the trade-names are often easier to spell and write than the generic name. For example, “Lasix®” is easier to write than “furosemide.” When the physician writes a prescription for “Lasix®”, and does not write “dispense as written” (DAW) and/or “brand medically necessary” (BMN) on the prescription, then the pharmacist is free to fill the prescription with either a trade-name or a generic. Therefore, a program that requires the dispensing pharmacist to use an available generic is mandatory.

A difficulty in administering a mandatory generic program is knowing which trade-name drugs actually have competing generic drugs available. Health Information Designs (HID) has a mechanism in place to solve this problem. HID has developed an “in-house” database of drugs called Drug Explorer™. The actions and make-up of this database have been submitted for a patent and the patent is pending. This database has over 80,000 National Drug Codes (NDC) and over 55,000 of these are known to be on the CMS rebate list. Consequently, HID can limit its study of trade-names and generics to drugs on the CMS rebate list. HID is uniquely positioned to administer a Mandatory Generic Program.


Utilizing Prior Authorization Programs >