September 06, 2017

Duexis is Back - Now What?

, Legislation
, Network Solutions

As published in the Wall Street Journal, combination medications have become a critical part of the conversation when it comes to prescription medication cost drivers and potential shortcomings within a Pharmacy Benefits Managers (PBMs). (See our previous post here.)

To recap: Horizon Pharma’s Duexis combines ibuprofen and famotidine, an antacid, into one tablet to combat upset stomach symptoms caused by taking ibuprofen, an NSAID commonly prescribed for pain. While taking one pill versus two may be more convenient, the single Duexis pill is exponentially more costly than taking the two common and inexpensive medications.

With the negative press, and pressure from customers, some PBMs responded by placing Duexis on their auto-convert list, treating it as if Duexis were a multi-source brand. Multi-source brands are those that have generics, while single source brands do not have generics. PBMs automatically convert multi-source brands to their generic equivalents. The issue is Duexis is not a multi-source brand, and therefore, not eligible for auto-conversions.

Recently, the Food and Drug Administration (FDA) approved a new label on the Duexis package insert to read: “Do not substitute Duexis with the single-ingredient products of ibuprofen and famotidine,” effectively stopping the systematic conversions of Duexis. 

However, manual conversions, where the PBM calls the prescriber for approval to convert while the member/patient is waiting at the pharmacy, continue without disruption. The FDA’s move is perplexing to those PBMs that were likely auto-converting, as they must now dedicate the resources to support manual conversions.

Does your PBM dedicate the resources to manually convert Duexis?

At CorVel, our Certified Pharmacy Technicians are available throughout the prior authorization process to work with dispensing pharmacies and prescribing physicians to convert Duexis and other unnecessary combination medications when appropriate. CorVel’s prospective PBM model offers our clients the resources they need to improve claims outcomes. 

For more information, reach out to your CorVel representative.