Getting Specific About Generic Drugs
It’s no surprise that generic drugs save you money. After all, they exist to be a less expensive version of their brand-name counterparts. But how much can you really save, how do you get them, and what are the basics about generic drugs? Here are answers to many of the questions members regularly ask.
What are generic drugs?
A less expensive version of brand-name drugs, generics are made with the same active ingredients and are available in the same strengths and dosages as brand names.
What process do generics go through for approval?
Generics must meet the same strict standards the FDA sets for brand-name drugs. They must be the same in the following ways:
- Active ingredient
- Strength, dosage form (i.e. tablet or injectable), and route of administration (i.e. oral or topical)
- Manufactured under the same strict standards as the brand-name drug
- Drug label, with certain exceptions
- Bioequivalent to the brand name
Do all drugs have generic equivalents?
No, some brand-name drugs are protected by patents for up to 20 years, so a generic cannot be produced immediately. However, about half of all prescription drugs on the market do have generic versions available.
How do I get a generic drug?
Blue KC takes care of this for members. When a generic equivalent is available, the Prescription Drug List (PDL)* for your Individual and Family Plan will generally include it instead of the brand name drug. Go here for the most recent Prescription Drug Lists based on your plan type. To feel completely confident that you’re getting the best price available, we encourage you to double check with your doctor or pharmacist.
How does Blue KC help me save money on generics?
Because your Blue KC PDL generally offers the generic instead of the brand name drug, we can offer you a lower price for your prescription. These real-life examples highlight your potential savings.
| Drug Name | Brand Name Out-of-Pocket Cost1,2 | Generic Out-of-Pocket Cost1,2 |
| Brand: Lyrica Generic: Pregabalin3 | $640/prescription | $14/prescription |
| Brand: Zestril Generic: Lisinopril3 | $452/prescription | $3/prescription |
Medication prices are not exact and may vary. The coverage and pricing terms of products are subject to change based on your Pharmacy benefits.
1Out-of-pocket cost until deductible is met
2Prescription cost for High Deductible Health Plan
3Suggested generic substitution
How else can I save money on prescription drugs?
Blue KC members can sign up for Rx Savings Solutions for additional ways to save money on prescription drugs. Learn more about Rx Savings Solutions.
Please contact Blue KC Customer Service with questions about prescription drug coverage or to talk about enrolling in a Blue KC health plan.
*The Prescription Drug List, also referred to as a formulary, is a list of prescription medications that have been reviewed and recommended by Blue KC’s Medical and Pharmacy Management Committee. Each medication has been reviewed for safety, effectiveness, clinical outcomes, and cost
