Generic drugs are priced much lower than the equivalent brand name versions - usually 30-75 percent less. Why? Generic drugs are less expensive because they do not require the same costly research, development, sales and marketing as brand name drugs. In fact, generic drugs are required to follow the same strict Food and Drug Administration (FDA) guidelines as brand name drugs. Many companies that manufacture brand name drugs also manufacture generic drugs.
Generic drugs have been used for various conditions for a long time with safe and effective results. Newer brand name drugs are more expensive, but they may not be any better. To find out whether a generic exists for your prescription, ask your doctor or pharmacist.
Generic Mandatory Drug Program
Beginning January 1, 2022, a generic mandatory program will apply to prescription benefits. If you purchase a brand-name drug which has an available generic equivalent, you will be responsible for the difference in the allowable charge for the generic versus the brand. This additional cost will be in addition to the copay for the requested brand-name drug. If your prescriber determines that the brand-name drug must be dispensed at the pharmacy, you will not be responsible for the difference in cost between the brand and generic products. Your prescriber must include this information on the prescription which is sent to your pharmacy.
Certain medications are classified as Narrow Therapeutic Index (NTI) drugs. This means that a small change in the dose or concentration of a medication can impact the medication’s effectiveness or potential toxicity. Your specific pharmacy benefits will determine whether or not you will be responsible for the difference in the allowable charge for a brand-name NTI medication when a generic equivalent drug is available.
Note: Prescription benefit plans may vary. Refer to your contract for the specific requirements of your prescription drug coverage.
You may access a list of NTI medications below. This list is subject to change.