Most prescription drugs, but there are also combination drugs that combine multiple medications into one. One example is prescription pain medications that combine oxycodone with acetaminophen or other common pain relievers. When two medications available as individual components are packaged together and sold under a new name, that’s a combination drug.
Have you ever walked through the grocery store or other product aisle and seen “new and improved” on a product? Sometimes the company adjusted the recipe to add more of a certain ingredient or perhaps they found a new way to produce it that makes it more effective. Whatever the reason, they generally get to increase the price on that new and improved product.
Combination drugs sometimes aren’t much different, because you usually end up paying more for them. When two drugs start being used in combination to treat a particular health concern, manufacturers may look for opportunities to combine them into a new drug—which often comes at a higher price than the two individual components purchased separately.
At MaxCare, we offer our SmartBlock program specifically to help companies avoid the added cost of these combination products. Our clinical services team regularly reviews clinical evidence to identify whether studies show that the combination drugs work better than the single components purchased individually at a lower price. Often, they do not.
As new drugs hit the market, our team reviews the clinical evidence and updates the list of acceptable combination medications for each client’s pharmacy benefits plan. When a higher-cost medication isn’t allowed on the plan, our clinical pharmacists recommend alternative options.
In many cases, if a patient has an identified need for a single medication rather than two separate medications, there’s a better option than the high-cost combination drugs. Many local community pharmacies still offer compounding services, where they can combine two prescriptions into one in their local pharmacy at a much lower cost than the new combination medication sold under a brand name.
If you’re concerned about the cost of combination drugs or specialty medications, contact MaxCare today to discuss how we help self-insured employers manage their pharmacy benefit costs.