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Mandatory Generic on a Group Benefit Plan

On a group benefit plan, there is often a lot of concern surrounding pharmacy coverage and the availability of Brand Name Prescriptions over having to choose a Mandatory Generic Substitution for your prescription medication needs.

What’s best and will this provide the same results if I accept the substitution? Good question.

Pills10thIn Canada, brand-name drugs have a 20-year patent protection. During this time, only the patent holder can produce the drug. After this time is up, other manufacturers may apply to Health Canada to produce generic versions. When Health Canada provides approval, governments, private insurance plans and consumers can benefit from the lower costing pharmaceutical.

Generics could best be described as a copycat of their brand name counterpart. They have the same active ingredients as the brand name variety and are as safe and effective to use. In addition, both generic and brand name drugs sold in Canada must be approved by the federal Health Protection Branch and must meet strict regulations established bythe Food and Drug Act.

The really important difference between a brand name and a generic is price. Generics can often cost 40-to-50% less than a brand name. Over the last few years, provincial governments have introduced legislation that reduced the cost of generic drugs offered on provincial formularies to 18-to-25% of the brand name prices.

The generic variety may have a different name and look slightly different, but the quality, safety, and effectiveness are equal. When used as prescribed, generic versus the more expensive brand name drug will save valuable health care dollars.

A “no-substitution” from a doctor on a plan where Mandatory Generic is required, involves a form completed by the patient’s doctor for approval of this additional cost on the benefit plan.

 


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