Monday, January 19, 2009

What is GFR?

Recently, I was presenting to a group that brought up the term GFR . In particular they were stating that the GFR for their plan was at nearly 100%. The plan board thought that GFR was the same as Generic substitution. I really think that their insurance carrier or paid consultant should have explained the difference until I realized that the consultant did not fully understand the terminology difference. So let me explain. Here in Canada most plans have a Generic Substitution policy where once a drug goes off patent then the plan will pay for the less expensive alternative. This is Generic Substitution Rate or GSR. Thus you should currently see Atorvastatin commonly known as Lipitor which is just facing several Generic equivalents have a high GSR. This just occurred in the last week or so, so you may not see it in your current carrier reports but it will impact future reports and should be at 95% +. The GFR rate refers to the number of prescriptions written or filled generically in your plan. In Canada last year the combined average GFR for Public and private plans was at about 54%. In the US that percentage is much higher at over 70% pointing to most prescriptions being written as a generic. Canada is ahead of the US in terms of the number of blockbuster drugs that have gone off patent so we have not done enough to try to take advantage of the lower costs with generics. Much debate is currently going on , as to how we get better pricing on these off patent medications.

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