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Effective April 1 of 2010, the price for existing generics listed on the Alberta provincial formulary has been reduced to 56% of the brand name cost. This reduced generic price applies for every pharmacy customer.

When new generic drugs enter the market and are added to Alberta's formulary they'll be priced at 45% of the brand name price. Alberta Health and Wellness will permit the existing higher pricing for a 60 day transition period to allow pharmacies to deplete any generic drug inventory purchased before April 1. Pharmacists will be required to charge the lower rate for any inventory purchased after April 1.

Most insurers will be changing their price files to reflect the new generic drug pricing as of June 1, 2010, which is at the end of the 60-day grace period.

Generic drugs that are not on the Alberta formulary, but are covered by private health plans, will not benefit from this new pricing. On average, 80%+ of generic drugs covered by insurers' drug plans are on the AB formulary and will benefit from the reduced generic pricing.

How will this affect plan sponsors? Based on an analysis from Sun Life, in year one the savings from the new generic pricing will be offset by the $3 transitional pharamcy allowance, with savings increasing marginally in years 2 to 3. In the long term, savings from lower generic drug pricing could be about 2% of current prescription drug costs.

Good news: BC's Ministry of Health Services, the BC Pharmacy Association (BCPhA) and the Canadian Association of Chain Drug Stores (CACDS) have negotiated a new Pharmacy Services Agreement that is now in effect. Although the agreement is not binding on individual pharmacies, it is expected that the majority will comply.

This is good news because employee benefits plan sponsors will benefit from the savings on lower cost generics on the BC PharmaCare formulary. The expected savings between October 15, 2010 and July 3, 2011 is estimated to be 3.7% of drug costs. Savings will vary significantly by plan depending on the coverage design and employee demographics.

As of Oct. 15th, 2010, new generic drugs will be priced at 42% of brand name, and existing generics will be priced at 50% of brand name. Starting in July 2011, all generics will move to 40%, and in April 2012, they will be even further reduced to 35% of brand name! 

In a move to appease pharmacies, dispensing fees will be rising slightly during the upcoming two years. Some benefits plans are designed to have a dispensing fee deductible, so the changes will not impact potential savings.

For more information, please feel free to call our office at 604.872.2866.

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