you may know, Medicare Part D prescription drug plans are allowed to update their plan formularies or drug lists throughout the plan
year and the April 2018
Medicare Part D formulary updates included 486 new drugs, including 57 new generic drugs - with 103 new generic equivalents
(variations of manufacturer, drug-strength, and packaging).
When your Medicare drug plan adds a new generic, you may find that you can save money by switching from your brand-name
drug to the newly-added generic equivalent – with your prescriber’s approval and a new
However, switching to a generic does not always guarantee a large savings. Medicare plan members need to look
carefully at their Medicare plan’s coverage as some new 2018 generics are being offered
on the same cost-sharing formulary tier as their brand-name equivalent and/or
the new generics do not have a significantly lower retail price.
For example, the brand-name drug Emend 40 MG
has a retail cost of
around $125 and, as a Tier 4 drug, has cost-sharing of 45% co-insurance. The same Medicare drug plan may cover the
generic equivalent APREPITANT 40 MG
, also as a Tier 4
drug (45% co-insurance) with an approximate retail cost of $88.
So you would pay approximately $56 for the brand-name drug Emend or $40 for the generic-equivalent drug Aprepitant - and people will need to decide whether the $16 savings is worth changing from a brand to a generic.
As noted above, you will need to check your Medicare plan's coverage details to learn more about what you would pay for the generic of brand-name drug. Looking closer at our example, the brand-name drug, Emend 40 MG
is covered on only seven (7) Medicare Part D plans
in Florida and has a retail price ranging from $117.37 to $124.80 – with plan cost-sharing
from $18 to $93
In comparison, 21 stand-alone
Medicare Part D
plans in Florida cover the generic Aprepitant 40 MG, with cost-sharing from a
$10 to $42
co-pay or co-insurance anywhere from 18% to 50% of retail
. This means your cost-sharing for this generic
drug could range from a $10 co-pay to $44 co-insurance
, depending on your
chosen Medicare Part D plan.
So in this specific example of Florida plans, you could pay anywhere from $18 to $93 for the brand drug or $10 to $44 for the generic. To learn
more, you can click here
to see how your Medicare
drug plan is covering these medications.
As a note, both our Formulary Browser
(you can view all the drugs covered by a single Medicare prescription drug plan) and our Q1Rx
(you can view all the Medicare drug plans covering a single drug) have been
updated with the April 2018 Medicare Part D formulary data.