Blue Cross Blue Shield of Michigan now is covering Prilosec OTC for heartburn and acid reflux disease, reflecting increasing attention from insurers to over-the-counter drugs as vehicles for savings.
Patients who switch from prescription proton pump inhibitor Nexium (esomeprazole) to Prilosec OTC or generic omeprazole will receive their first prescription or supply for free and will pay their normal generic drug copay on subsequent refills, the insurer announced.
Officials at Blue Cross Blue Shield of Michigan (BCBSM) estimate that members of the plan will save $9 million in out-of-pocket costs because of the switch; 1.5 million patients are insured by BCBSM, whose customer groups have agreed to the program.
Some patients may save about $130 a year using Prilosec OTC instead of Nexium, according to the company, which added that employers could save nearly $20 million in the first year.
“The majority of our members will find that over-the-counter or generic Prilosec will provide the same benefit as the brand name,” said James Lang, vice president for pharmacy services. “We encourage them to discuss making this change with their doctor.”
The coverage decision builds on previous strategies employed by BCBSM and other insurers to drive patients toward lower-cost drug options such as generics and OTCs.
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