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Generic Prescriptions
Understanding Therapeutic
Substitution
By Claims and Benefits, Inc, A Noridian Company

CBI UpFront Newsletter October 2006
Not every brand-name drug has a generic equivalent, "but that doesn't necessarilymean you are stuck using a pricier brand-name product," says Bethany Pfister, aclinical pharmacist with Prime Therapeutics, a regional pharmacy benefits manager.
You may be a candidate for a generic alternative.
What's the difference?
The terms "generic equivalent" and "generic alternative" are easy to mix up. Ageneric equivalent is a chemical copy of the brand-name medication, which means ithas the same active ingredients. If you were to switch from a brand-name drug to a generic equivalent, the dosage would stay the same.
Q: Do insurance companies really care
A generic alternative is a copy of a different brand name drug, but it belongs to thesame class of drugs used to treat a particular condition. A generic alternative has whether I have a safety program for
been shown to be safe and effective to treat that medical condition, but it may con- our company?
tain different active ingredients.
A. Any reputable insurance carrier would If you were to switch from a brand-name drug to a generic alternative, the dosage be extremely interested in not only the could be different, Pfister says. This practice is known as therapeutic substitution.
type of program but also how it is imple- How does therapeutic substation work?
mented and who is responsible for The selective serotonin reuptake inhibitors, or SSRIs, are an example of the class of administering/valuating the program. drugs most commonly used to treat depression, she says. Of the five drugs in thatclass, generic equivalents of four of the brand-name products are available. If a Just having the "required OSHA/safety patient was taking the only brand-name product in that class, therapeutic substation manuals and regulations" sitting on a could be used to switch to a lower-cost generic alternative.
shelf looks nice but does not reflect a While therapeutic substitution is a way to help patients save on prescription drugs, it good safety program/culture. Employee doesn't work for everyone, Pfister notes. "Be aware that your doctor may have a attitude/training, loss histories, work valid medical reason for prescribing a specific brand-name drug," she says. Side area conditions, management, attitude, effects, for example, vary by individual, and you might tolerate one drug in the classbetter than others.
etc. are the true measurements of a pro- gram that works. Another thing to note is that if you are taking a brand-name medication, your phar-macist may fill a prescription with a generic equivalent unless your doctor writes If your program has been successful "brand necessary" on the prescription or you specifically say you want the brand- "rate credits" may be given on certain name product. The pharmacy, however, needs permission from your doctor to use a lines of coverage to reflect your efforts in generic alternative to drugs that do not have generic equivalents.
maintaining a safe environment for your Looking to save money?
employees and customers. Using a generic is one way you can cut your drug costs. Over-the-counter medica- Visits by the loss control representative tions are another option.
should be viewed as a positive step that If the patent on a well-known brand-name product is about to expire, the drug com- your selected carrier is taking to help pany may apply to the Food and Drug Administration to sell the product over-the-counter, or OTC. "Selling an over-the-counter drug provides a way for the drug com- you prevent or reduce losses which bene- pany to keep the profits of its name brand and to compete with other drugs used to fits both parties. treat that condition, including the generic version of the drug," Pfister explains.
There are organizations that specialize in The same dosage of a well-known heartburn medication, for example, is sold as a providing the books, manuals and even brand-name prescription called Prilosec, a generic prescription called omeprazole conduct the necessary employee training and an over-the-counter medication called Prilosec OTC. Even though the threedrugs have the same active ingredient and dosage and are expected to have the same that is required by the various regulatory effect, the prices vary significantly, Pfister notes. Prilosec OTC costs about 85 per- laws. Utilizing one of these companies cent less than brand-name Prilosec and about 55 percent less than generic Prilosec.
may be of benefit to you as then you and Find out more
your employees can concentrate on per- If you are looking for ways to reduce your prescription drug costs, initiate a conver- forming the tasks that make your compa- sation with your doctor. "Unless patients bring up the subject, physicians generally ny successful. Contact your insurance do not know the extent of the patient's insurance coverage or the amount of out-of- agent if you have questions. pocket costs the patient is able or willing to pay," Pfister says.
East Central Region Expands
By Dale Lieb, Regional Sales Manager

The states of Minnesota, Iowa and the products and services we have to offer in southern portion of South Dakota make up our entire region.
the East Central Region of Ag States. In Rob Franklin has been hired as the Account the past couple years, we have expanded Executive to handle this new expansion our target markets to include implement area for Ag States Group. Rob offices in dealers, rural telcom companies, beverage Tulsa, Oklahoma and brings 17 years of distributors, ethanol plants, biodiesel plants, insurance experience with him. He most nurseries, and wholesale food and fruit and recently worked for Nationwide Agribusiness in the same territory so he is Recently, we have expanded our region's well known in the area. Rob can be geographical footprint into the states of reached at (918) 749-2435.
Our Promise to our Customers.
Oklahoma and Arkansas. Our current book We encourage referrals of customers who At Ag States Group, we provide clarity to of business in these states is made up of may need our services throughout the risk issues so you can focus on business. agribusiness and petroleum, but a strong region to any of our Account Executives.
push is underway to write grain elevators, Thank you for your past referrals which bringing more insurance alternatives to C O N T A C T S
have contributed to our growth. Your cus- these states. We welcome these new cus- tomer loyalty provides the solid foundation Corwin Tufte
tomers to Ag States Group, and also wel- for our continued growth strategies. Thank President & General Manager come any new prospects to explore what you for your business.
Bill Gleason
Director of Sales Winners of Visa Gift Card
In the months of August, September, and October we ran a weekly drawing to win a $25 Products Manager Visa Gift Card. In order to be eligible for this drawing our customers had to submit achange request at www.agstatesgroup.com within that week. The following are all the win- Wendy Byl
ners from that drawing. Congratulations to them and Thank you for using our newly updated website offering many new online services.
Mike Phelps
Jill – North Star Bean Sherri – Chamberlin Distributing Diversified Services Manager Cindy – Prince Corporation Dennis – Farmers Union Oil Co Bill Willard
Robert – Big Horn Cooperative Marketing Sharon – Global Organics LLC Daseke Agency Manager Pete – Ag Valley Coop Cheryl – Mouws Feed and Grain Laura – Murakami Farms Inc Rick – Agri Coop Michael – Landmark Services Cooperative Karen – Centrol Inc Ag States Group
Dianna – Edwall Chemical Corporation St. Paul, MN 55164 Phone: 800-548-1494 Fax: 651-355-6359

Source: http://www.daseke.net/media.asp?f=newsletter%20winter%2007.pdf

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UNITED STATES DISTRICT COURT DISTRICT OF NEW JERSEY IN RE SCHERING-PLOUGH Civil Action No. 08-397 (DMC) (JAD) CORPORATION / ENHANCE SECURITIES LITIGATION NOTICE OF PENDENCY OF CLASS ACTION All persons and entities that purchased or acquired Schering-Plough Corporation ("Schering") common stock, 6% mandatory convertible preferred stock maturing August 13, 2010 ("Preferred Stock"), or call options, and/or sold

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2013 CLINICIAN'S GUIDE TO PREVENTION AND TREATMENT OF OSTEOPOROSIS Attention Clinicians: It is important to note that the recommendations developed in this Guide are intended to serve as a reference point for clinical decision-making with individual patients. They are not intended to be rigid standards, limits or rules. They can be tailored to individual cases to incorporate personal facts that are beyond the scope of this Guide. Because these are recommendations and not rigid standards, they should not be interpreted as quality standards. Nor should they be used to limit coverage for treatments. This Guide was developed by an expert committee of the National Osteoporosis Foundation (NOF) in collaboration with a multi-specialty council of medical experts in the field of bone health convened by NOF. Readers are urged to consult current prescribing information on any drug, device or procedure discussed in this publication. National Osteoporosis Foundation 1150 17th St., NW, Suite 850, Washington, DC 20036 © REVISED 2013. National Osteoporosis Foundation (NOF). All rights reserved. No part of this Guide may be reproduced in any form without advance written permission from the National Osteoporosis Foundation. BoneSource® is a registered trademark of the National Osteoporosis Foundation. Suggested citation: National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Washington, DC: National Osteoporosis Foundation; 2013.