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First generics for Lyrica® arrive to market ― significant savings expected

by Mary McNitt | Aug 06, 2019

The Workers’ Compensation Medicare Set Aside (WCMSA) portal has been updated to reflect some of the generic formulations of Lyrica® (updates listed below). We expect to see significant savings with the addition of these generics to the marketplace.

Lyrica (an anti-epileptic drug (AED) used for neuropathic pain) is the most common brand name drug seen in WCMSAs. Due to the high cost of the brand formulation of this medication, generic alternatives have been eagerly anticipated.

On July 19, 2019, the Food and Drug Administration (FDA) approved the first generic drug applications for Lyrica. Nine manufacturers were granted approval for generic pregabalin: Alembic Pharmaceuticals, Alkem Laboratories, Amneal Pharmaceuticals, Dr. Reddy’s Laboratories, InvaGen Pharmaceuticals, MSN Laboratories Ltd., Rising Pharmaceuticals, Inc., Sciegen Pharmaceuticals Inc., and Teva Pharmaceuticals.

Effect on WCMSA costs
The chart below indicates the pricing reflected in the WCMSA Portal as of the August update for brand and generic formulations of Lyrica.

Brand
(Manufacturer)

Generic
name

Drug
usage

Brand AWP price
per unit

Generic
price

Lyrica (ParkeDavis, Div. of Pfizer)

Pregabalin

Anti-convulsant for neuropathic pain

$9.36/Capsule

$7.58/Capsule for the following strengths: 100 mg, 150 mg, 50 mg, 75 mg
$8.42/capsule for the following strengths: 200 mg, 225 mg, 25 mg, 300 mg


More pricing fluctuations expected
The current pricing of generic pregabalin that we are seeing in the WCMSA portal does not reflect all of the generic products that are currently in RED BOOK®. The large number of pregabalin generics approved in July 2019 caused price pressure and we have identified other generic manufacturer pricing that is much lower. We anticipate that the lower pricing will be included in the September WCMSA portal update. The lowest Average Wholesale Price (AWP) pricing in RED BOOK as of August 1, 2019 is noted in the chart below.

Pregabalin dosage

Manufacturer

AWP per capsule^

25 mg, 50 mg, 75 mg, 100 mg

Novadoz Pharmaceuticals

$0.57

150 mg

Novadoz Pharmaceuticals

$0.67

200 mg

Novadoz Pharmaceuticals

$0.73

225 mg, 300 mg

Novadoz Pharmaceuticals

$0.80


^Pricing from RED BOOK

Please note, CMS generally requires generic medication fills reflected on invoices to allow allocation for a generic drug.

OWCA recommendation
Generic medications can bring down medication costs significantly. It is our recommendation that carriers, TPAs and claim handlers review cases where brand Lyrica has been prescribed to determine the benefit from decreased cost with transition to the generic formulation. We will proactively reach out to our clients in reference to previously completed WCMSAs where Lyrica was prescribed.

Future updates
We continually monitor the RED BOOK AWP changes for the most common medications in WCMSAs, as well as generic medications that come to market, and will keep the industry informed.

As an established Medicare Secondary Payer (MSP) compliance services provider, one of Optum Workers’ Comp goals is to keep clients and the property and casualty insurance industry informed of changes affecting MSP compliance and WCMSAs.

Sources:

  1. RED BOOK http://www.micromedex.com/products/redbook/awp/
  2. WCMSA Portal https://www.cob.cms.hhs.gov/WCMSA/login
  3. FDA press release July 22, 2019 https://www.fda.gov/drugs/drug-and biologic-approval-and-ind-activity-reports/first-generic-drug-approvals

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