Blue Cross is committed to ensuring that all of our members can get safe, effective and affordable prescription medications when they need them.

The good news is that generics— which can treat symptoms or conditions in an equally effective manner as the brand-name drug— are as popular as they are affordable. Today, generics make up more than 90 percent of all prescriptions filled by our members. The average cost of a generic medication is $28 a month.

The bad news? Drug manufacturers continue to offset the lower prices of generics by continually ramping up the prices on brand-name specialty medications. While these drugs account for less than two percent of all prescriptions, they represent more than half of all prescription costs. The average cost of a brand-name specialty medication is $6,000 a month.

The trend of these skyrocketing prices shows no sign of slowing down. In fact, a recent report from GoodRx found that drug manufacturers increased the price of a record 816 different medications in 2021.

Challenging unaffordable prescription drug costs

One way Blue Cross is taking on the unsustainable rise in the cost of prescription drugs is through a class action lawsuit recently filed against Vyera Pharmaceuticals and others, challenging their monopolistic practices, which allowed them to impose massive price hikes on patients.

In 2015, Vyera purchased the rights to a drug called Daraprim* and in short order, raised the price per pill from $17.50 to $750— an increase of more than 4,000 percent. Most patients requiring this medication need to take multiple doses of Daraprim per day and the course of treatment can last weeks or months.

And while co-pays and co-insurance can provide important financial protections for those with health insurance, what insurers pay for those medications ultimately impacts premiums for everyone.

Generic drugs help keep costs down

When brand-name drug manufacturers intentionally limit generic competition, they can set prices arbitrarily, with no oversight or approval process.

This was the case with Vyera Pharmaceuticals. Prior to the first generic alternative made available in March 2020, Vyera controlled 100 percent of the market for this medication in the United States, allowing them to set prices however they chose— with no market competition.

The lawsuit that Blue Cross recently filed against Vyera argues that the company actively prevented generic drug companies from acquiring Daraprim samples and the ingredients needed to develop lower-cost alternatives. We allege this behavior allowed Vyera to unlawfully monopolize the market.

Simply put, Blue Cross believes this type of business behavior is wrong and inexcusable. We are committed to holding drug companies accountable for any illegal and unethical practices that drive up medication prices solely in pursuit of profit.

The average cost of a generic medication is $28 a month. The average cost of a brand-name specialty medication is $6,000 a month.

Additional programs to address drug costs

Blue Cross is committed to helping our members find and use lower-cost alternatives. That is why Blue Cross has a process in place to inform pharmacies when a high-priced drug is not included in a member’s benefits, while simultaneously letting them know about a lower-cost option. This could be a generic alternative or a different brand-name drug that treats the same condition.

For example, some prescription drugs combine two over the counter (OTC) medications into one pill. It doesn’t make sense to buy one combination drug if purchasing two OTC drugs separately would be less expensive.

Another way Blue Cross members can save money is by using our drug cost estimator tool. Blue Cross members who have Prime Therapeutics as their pharmacy benefit manager have access to this tool, which provides various medication costs via their online member portal or through the Blue Cross MN mobile app.

Creating a sustainable health care ecosystem

Ensuring our members’ physical and financial health and wellbeing will always be our priority. To learn more about what Blue Cross is doing to create a sustainable health care system in Minnesota and beyond, visit bluecrossmn.com/sustainability.

*Daraprim is the leading treatment for toxoplasmosis, a parasitic infection that can be deadly for those with compromised immune symptoms or other serious health conditions like cancer or HIV/AIDS.