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Health Care Pharmacies are quick about switching to the generic form of Prozac

You’d think that when Barr Laboratories Inc. announced it won its long battle to sell a generic form of Prozac, pharmacies everywhere would rush to buy it.

Two of San Diego’s largest health care providers, however, aren’t among them.

Both Kaiser Permanente and UCSD say they’ll stick with Eli Lilly and Co.’s antidepressant Prozac , at least until Barr Laboratories of Pomona, N.Y., or another generic seller offers them a better deal.

However, both health providers say patients who pay out of pocket will save on Barr’s generic version of fluoxetine, the main ingredient in Prozac.

Barr received regulatory approval for generic Prozac on Aug. 2 after a protracted patent battle with Eli Lilly.

The firm expects 180 days of market exclusivity before other generic sellers get in the act.

Gordon McGuire, senior pharmacist at UCSD’s Medical Center, said he didn’t rush to buy the generic pills because wholesalers offered him a better discount on Prozac , $1.50 per 20 mg Prozac capsule vs. $2.05 each for the generic version.

McGuire said many health plans have already indicated they will no longer cover Prozac, forcing him to switch to the generic version.


Generics Cost Less

UCSD patients who buy the drug out of pocket will save $10 for a one-month supply of 20 mg pills , that is $85 for the generic vs. $95 for the brand version, he said.

Experts say generic firms normally discount a drug between 20 and 40 percent from the branded price during the first six months.

But McGuire finds that dramatic discounts typically result from stiffer competition.

“Back when Valium was the absolute thing it went down by a factor of 10 and that was when half of the world was on Valium,” McGuire said.

He predicts in about a year, a 30-day supply of generic 20 mg fluoxetine pills may sell for as low as $7.50.

Dr. Rodrigo Mu & #324;oz, a psychiatrist in private practice in Hillcrest, said he’s worried that even the generic will be too costly.

“I think (paying) two-thirds (less for the drug) is still too much,” Mu & #324;oz said. “It’s disappointing that companies that didn’t incur costs for research and development are going to have a costly product on the market.”

Kenneth Schell, manager of ambulatory care operations for Kaiser pharmacies in San Diego, said the HMO will buy its pills directly from Eli Lilly at least for another six months.

He declined to comment on pricing.

David Campen, who is in charge of Kaiser’s Northern California pharmacy unit, told the San Francisco Chronicle he expects the price the HMO charges to drop by 90 percent.

Dr. Dennis Cook, chief of psychiatry and addiction medicine at Kaiser’s Point Loma facility, said few patients pay out of pocket for prescriptions.

Although Prozac ranks among the top-prescribed antidepressants at Kaiser, there are lower-priced and equally effective antidepressants available, he said.


Widely Prescribed

Behind Prozac’s success is its widely prescribed use, ranging from depression and severe premenstrual syndrome to obsessive-compulsive disorder, and generalized anxiety and panic disorders.

The popular pill is the largest-selling drug ever to lose patent protection. Prozac generated $2.6 billion last year.

The battle over Prozac has rekindled the debate over the costs of medicine and tactics used by drugmakers to extend their patent-protected pricing.

Drugmakers search for innovative ways to create new patents. Eli Lilly, for instance, recently patented a new time-release version of Prozac. The once-a-week form of Prozac is equivalent to the 20 mg-a-day dose, Cook said.

However, Cook said the time-release Prozac does not have much flexibility in dosages. “Some patients need more (of the drug), some need less depending on their side-effects,” he said.

Other companies are eager to cash in on Prozac’s success.

Among them is a German unit of drugmaker Merck, the Spring Valley, N.Y.-based Pharmaceutical Resources Inc., Jerusalem-based Teva Pharmaceutical Industries Ltd. and Geneva Pharmaceuticals Inc., a unit of Swiss drug company Novartis AG.

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