3. 2 | P a g e
Background
Due to the removal of 25 Pfizer drugs from the patient assistance program (PAP), the Shared Care Free
Clinic will need to analyze different avenues for providing medications to its patients. There is a
significant need to replace these medications for the patients of the Shared Care Free Clinic. Over 500
ninety day prescriptions were filled in 2012 for various chronic disease states (e.g., high blood pressure,
high cholesterol, diabetes, depression, and other mental health issues).
Of the 25 drugs that will be discontinued, the following drugs are the ones that will have an impact on
the clinic:
1. Accupril (Quinapril)
2. Aldactone (Spironolactone)
3. Alzulfidine (Sulfasalazine)
4. Cardura (Doxazosin)
5. Geodon (Ziprasidone)
6. Glucotrol (Glipizide)
7. Glucotrol XL (Glipizide XL, ER)
8. Lipitor (Atorvastatin)
9. Neurontin (Gabapentin)
10. Norvasc (Amlodipine)
11. Zoloft (Sertraline)
Objective
The goal of this report is to give a cost analysis of the different options available to replace the 11
medications being removed from the Pfizer PAP. We will be evaluating the most economical
alternatives for replacing these medications and the alternatives include:
50 Plus Pharmacy
Rx Outreach1
Auburn Pharmacy2
Walmart3
, Target4
, and Hyvee5
There will be some advantages and disadvantages to each of these alternatives. If the clinic wanted to
only include options that relieves patients’ financial burden, then they would only consider: 50 Plus
Pharmacy, Auburn Pharmacy, and Rx Outreach. In all three of these alternative medication sources, the
clinic will be paying for the cost of medications. However, with each of these options they will have
different issues to consider. If the clinic orders from 50 Plus Pharmacy, then they will need to consider
the additional burden to the dispensary to fill those extra prescriptions. If they chose Auburn Pharmacy,
they would still need to utilize 50 Plus Pharmacy because Auburn Pharmacy does not have a
comprehensive list of medications. If they chose Rx Outreach, they will have the same issues as Auburn
(limited medication list), but they would also have a possible fluctuation in pricing. Rx Outreach does
4. 3 | P a g e
not have a set or constant pricing scheme available. Meaning, if the market prices for certain
medications increase, so will the costs they charge to the clinic.
If the clinic chose to place the financial burden on patients, patients would have to get their
prescriptions filled at Walmart, Target, Hyvee, or Auburn Pharmacy for the most economical option.
Walmart, Target, and Hyvee pharmacies have $4 prescriptions for a 30 days supply, or $10 prescriptions
for a 90 days supply. Auburn Pharmacy has $12 prescriptions for a 90 days supply. On top of financial
burden, many of these discount prices also have a limited medication list and do not include all of the 11
medications being discontinued from the Pfizer PAP. If patients went to Walmart, Target, Hyvee, or
Auburn Pharmacy, the clinic would still have to consider purchasing some medications from 50 Plus
Pharmacy due to the limited selection of drugs on their discount lists. Some advantages and
disadvantages to utilizing each alternative are listed in the tables below.
50 Plus Pharmacy
Advantages Disadvantages
•No charge for
patients
•Clinic pays the cost
•Greater work load for
the dispensary
Walmart, Target, Hyvee
Advantages Disadvantages
•No extra burden on
the dispensary
•Patients must pay the
$4 for 30 days supply or
$10 for 90 days supply
•Prices will stay
constant
•Med list may change
Auburn Pharmacy
Advantages Disadvantages
•No charge for
patients
•No extra burden on
the dispensary
•Patients have more
convenient times to
pick up medications
•Clinic pays cost
•Prices will stay
constant at $12 for a
90 days supply*
•Med list may change
*
Rx Outreach and 50 Plus
Pharmacy~Prices may fluctuate
with the market prices.
Rx Outreach
Advantages Disadvantages
•No charge for
patients
•No extra burden on
the dispensary
•Clinic pays cost
•Prices may fluctuate
if market prices
fluctuate
•Med list may change
5. 4 | P a g e
Methods
The 2012 report of medications filled through PAP was used to analyze how many of the discontinued
Pfizer prescriptions were filled throughout the year. The report was formatted in Excel and the sort
option was utilized to filter out the 11 Pfizer drugs of interest. For each drug, the number of 90 day
prescriptions was tallied. Results were all recorded into Excel sheets and costs of each alternative
source (50 Plus Pharmacy, Auburn Pharmacy, Rx Outreach, Walmart, Target, and Hyvee) were calculated
and annualized.
Results
From the data that was analyzed, results were annualized and placed into chart format. A few
discussion points were included to provide a more comprehensive view of each alternative (50 Plus
Pharmacy, Auburn Pharmacy, Rx Outreach, Walmart, Target, and Hyvee) if chosen.
6. 5 | P a g e
Pfizer drug: Accupril
Number of 90 day fills in 2012: 160
Possible substitutes: Quinapril or Lisinopril
Quinapril is not available at Auburn Pharmacy, Walmart, Target, or Hyvee. The only two options are
either 50 Plus Pharmacy or Rx Outreach. The annual cost of ordering from Rx Outreach ($17,600.00)
exceeds that of 50 Plus Pharmacy ($3,442.30). The additional script volume for the dispensary is 160
annually.
The other drug option for replacing Accupril is to switch patients to Lisinopril.
Quinapril
50 Plus Pharmacy: $3,442.30
Rx Outreach
o 90 days supply: $19,200.00
o 180 days supply: $17,600.00
50 Plus Pharmacy: $11.87 per 90 tablet bottle
Rx Outreach: $30 for a 90 days supply
$55 for a 180 days supply
7. 6 | P a g e
Lisinopril
50 Plus Pharmacy: $1,075.62
Rx Outreach: $5,760.00
Auburn Pharmacy: $7,680.00
Walmart, Target, Hyvee
o 30 days supply: $11,424.00
o 90 days supply: $9,520.00
50 Plus Pharmacy: Prices vary depending on strength and
bottle size.
Rx Outreach: $9 for a 90 days supply, $18 for a 180 days
supply
Auburn Pharmacy: $12 for a 90 days supply
Walmart, Target, Hyvee: $4 for a 30 days supply,
$10 for a 90 days supply
• Pfizer drug: Accupril
• Number of 90 day fills in 2012: 160
• Possible substitutes: Quinapril or Lisinopril
To avoid placing financial burden on patients, the clinic can order Lisinopril from 50 Plus Pharmacy,
Auburn Pharmacy, or Rx Outreach. The annual cost of ordering Lisinopril from 50 Plus Pharmacy will be
$1,075.62 and an additional 160 scripts for the dispensary to fill per year. The annual cost of ordering
Lisinopril from Auburn Pharmacy would be $7,680.00. At Auburn Pharmacy, the clinic can forward 90
day prescriptions for the cost of $12 each. If Rx Outreach was utilized, the annual cost would be
$5,760.00. For both of the Auburn Pharmacy and Rx Outreach options, there would be no additional
burden on the dispensary.
If patients are able to purchase Lisinopril, the options will be: Walmart, Target, or Hyvee. Patients can
fill a 30 days supply for $4 or a 90 days supply for $10. The total annual cost for patients would be either
$11,424.00 (30 days supply) or $9,520.00 (90 days supply).
8. 7 | P a g e
Pfizer drug: Aldactone
Number of 90 day fills in 2012: 33
Possible substitute: Spironolactone
To avoid placing financial burden on patients, the clinic can order Spironolactone from 50 Plus
Pharmacy, Auburn Pharmacy, or Rx Outreach. The annual cost of ordering Spironolactone from 50 Plus
Pharmacy will range between $370.10 and $484.33 (depending on bottle size ordered) and an additional
33 scripts for the dispensary to fill per year. The annual cost, if ordering from Auburn Pharmacy, will be
$1,632.00. At Auburn Pharmacy, the clinic can forward 90 day prescriptions for the cost of $12 each. If
Outreach was utilized, the annual cost would be $1,360.00. For both of the Auburn Pharmacy and Rx
Outreach options, there would be no additional burden on the dispensary.
If patients are able to purchase Spironolactone, the options will be: Walmart, Target, or Hyvee. Patients
can fill a 30 days supply for $4 or a 90 days supply for $10. The total annual cost for patients would be
either $1,632.00 (30 days supply) or $1,360.00 (90 days supply).
Spironolactone
50 Plus Pharmacy: $370.10
Rx Outreach: $1,360.00
Auburn Pharmacy: $1,632.00
Walmart, Target, Hyvee
o 30 days supply: $1,632.00
o 90 days supply: $1,360.00
50 Plus Pharmacy: Prices vary depending on strength and
bottle size.
Rx Outreach: $20 for a 180 days supply Auburn Pharmacy:
$12 for a 90 days supply
Walmart, Target, Hyvee: $4 for a 30 days supply,
$10 for a 90 days supply
9. 8 | P a g e
Pfizer drug: Alzulfidine
Number of 90 day fills in 2012: 1
Possible substitutes: Sulfasalazine
Sulfasalazine is not available at Auburn Pharmacy, Walmart, Target, or Hyvee. The two options are 50
Plus Pharmacy and Rx Outreach. When ordering from 50 Plus Pharmacy, the annual cost will range
between $32.32 and $58.60. There will be a minimal additional workload for the dispensary. Rx
Outreach will have an annual cost of about $200.00 and no additional burden on the dispensary. The
most economical option will be to order Sulfasalazine from 50 Plus Pharmacy.
Sulfasalazine
50 Plus Pharmacy: $32.32
Rx Outreach
o 90 days supply: $200.00
o 180 days supply: $190.00
50 Plus Pharmacy: Price varies depending on bottle size
Rx Outreach: $50 for a 90 days supply
$95 for a 180 days supply
10. 9 | P a g e
Pfizer drug: Cardura
Number of 90 day fills in 2012: 28
Possible substitutes: Doxazosin
To avoid placing financial burden on patients, the clinic can order Doxazosin from 50 Plus Pharmacy,
Auburn Pharmacy, or Rx Outreach. The annual cost of ordering Doxazosin from 50 Plus Pharmacy will be
$468.62 and an additional 28 scripts for the dispensary to fill per year. The annual cost of ordering from
Auburn Pharmacy will be $1,344.00. At Auburn Pharmacy, the clinic can forward 90 day prescriptions
for the cost of $12 each. If Rx Outreach was utilized, the annual cost would be $1,120.00. For both of
the Auburn Pharmacy and Rx Outreach options, there would be no additional burden on the dispensary.
If patients are able to purchase Doxazosin, the options will be: Walmart, Target, or Hyvee. Patients can
fill a 30 days supply for $4 or a 90 days supply for $10. The total annual cost for patients would be either
$1,344.00 (30 days supply) or $1,120.00 (90 days supply).
Doxazosin
50 Plus Pharmacy: $468.62
Rx Outreach: $1,120.00
Auburn Pharmacy: $1,344.00
Walmart, Target, Hyvee
o 30 days supply: $1,344.00
o 90 days supply: $1,120.00
50 Plus Pharmacy: Prices vary depending on strength but
approximately $12 per 100 count bottle
Rx Outreach: $20 for a 180 days supply
Auburn Pharmacy: $12 for a 90 days supply
Walmart, Target, Hyvee: $4 for a 30 days supply,
$10 for a 90 days supply
11. 10 | P a g e
Pfizer drug: Geodon
Number of 90 day fills in 2012: 4
Possible substitutes: Ziprasidone
Ziprasidone is not available at Auburn Pharmacy, Walmart, Target, Hyvee, or Rx Outreach. The only
option is 50 Plus Pharmacy. When ordering from 50 Plus Pharmacy, the annual cost will be $2,039.04
and an additional four scripts to fill in the dispensary.
Ziprasidone
50 Plus Pharmacy: $2,039.04
50 Plus Pharmacy: Cost of one 60 count bottle is $254.88.
12. 11 | P a g e
Pfizer drug: Glucotrol
Number of 90 day fills in 2012: 1
Possible substitutes: Glipizide
To avoid placing financial burden on patients, the clinic can order Glipizide from 50 Plus Pharmacy,
Auburn Pharmacy, or Rx Outreach. The annual cost of ordering Glipizide from 50 Plus Pharmacy ranges
between $9.60 and $25.20 (depending on bottle size ordered) and an additional one script for the
dispensary to fill per year. The annual cost if ordering from Auburn Pharmacy will be $48.00. At Auburn
Pharmacy, the clinic can forward 90 day prescriptions for the cost of $12 each. If Rx Outreach was
utilized, the annual cost will be $40.00. For both of the Auburn Pharmacy and Rx Outreach options,
there would be no additional burden on the dispensary.
If patients are able to purchase Glipizide, the options will be: Walmart, Target, or Hyvee. Patients can
fill a 30 day supply for $4 or a 90 day supply for $10. The total annual cost for patients would be either
$48.00 (30 days supply) or $40.00 (90 days supply).
Glipizide
50 Plus Pharmacy: $9.60
Rx Outreach: $40.00
Auburn Pharmacy: $40.00
Walmart, Target, Hyvee
o 30 days supply: $48.00
o 90 days supply: $40.00
50 Plus Pharmacy: Prices vary depending on bottle size.
$4.80 per 100 count bottle and $25.20 per 500 count bottle
Rx Outreach: $20 for a 180 days supply
Auburn Pharmacy: $12 for a 90 days supply
Walmart, Target, Hyvee: $4 for a 30 days supply,
$10 for a 90 days supply
13. 12 | P a g e
Pfizer drug: Glucotrol XL
Number of 90 day fills in 2012: 8
Possible substitutes: Glipizide XL, ER
Similar to Accupril (Quinapril), the clinic can only order the Glipizide XL, ER from 50 Plus Pharmacy or Rx
Outreach. This drug is not available through Auburn Pharmacy, Walmart, Target, or Hyvee. The annual
cost of ordering Glipizide from 50 Plus Pharmacy ranges between $313.93 and $323.00 (depending on
strength and bottle size ordered) and an additional 8 scripts for the dispensary to fill per year. If Rx
Outreach is utilized, the annual cost would be $1,120.00 (90 days supply) and $1,040.00 (180 days
supply), but there will be no additional burden on the dispensary to fill extra scripts.
Glipizide XL, ER
50 Plus Pharmacy: $313.93
Rx Outreach
o 90 days supply: $1,120.00
o 180 days supply: $1,040.00
50 Plus Pharmacy: Prices vary depending on strength and
bottle size.
Rx Outreach: $35 for a 90 days supply, $65 for a 180 days
supply
14. 13 | P a g e
Pfizer drug: Lipitor
Number of 90 day fills in 2012: 127
Possible substitutes: Atorvastatin,
Crestor, or Pravastatin
The options for replacing Lipitor include ordering Atorvastatin from 50 Plus Pharmacy or Rx Outreach.
And an alternative option is switching patients to therapeutically equivalent high cholesterol drugs like
Crestor or Pravastatin. Atorvastatin is not available at Auburn Pharmacy, Walmart, Target, or Hyvee.
The annual cost of Atorvastatin from 50 Plus Pharmacy will be $2,228.92 plus an additional 127 scripts
for the dispensary to fill per year. The annual cost of Atorvastatin from Rx Outreach will be $12,700 (90
days supply) and $11,430 (180 days supply).
Atorvastatin
50 Plus Pharmacy: $2,228.92
Rx Outreach
o 90 days supply: $12,700.00
o 180 days supply: $11,430.00
50 Plus Pharmacy: Prices vary depending on strength and
bottle size.
Rx Outreach: $25 for a 90 days supply, $45 for a 180 days
supply
15. 14 | P a g e
If switching to Crestor, there will be no additional cost. Crestor is available on the Astra Zeneca PAP.
The following list of equivalencies can be used to convert patients from Lipitor to Crestor6
. See Table 1
in the Appendix for conversion chart.
Lipitor 20mg= Crestor 5mg (n=61)
Lipitor 40mg=Crestor 10mg (n=8)
Lipitor 80mg=Crestor 20mg (n=3)
However, this conversion to Crestor would not include the patients currently prescribed Lipitor 10mg,
unless they are switched to ½ tablet of the Crestor 5mg (n=55). Another conversion that can be utilized
is to convert the Lipitor 10mg patients to Pravastatin 40mg. The following list of equivalencies can be
used to convert patients from Lipitor to Pravastatin:
Lipitor 10mg=Pravastatin 40mg (n=55)
If patients were converted to an equivalent dose of Pravastatin 40mg, they will be able to purchase their
scripts on the $4 discount list for a 30 days supply and $10 for a 90 days supply. The annual cost for
patients to switch from Lipitor 10mg to Pravastatin 40mg would be $2,640.00 (30 days supply) and
$2,200.00 (90 days supply). These annual costs are for Walmart, Target, and Hyvee. Results are
displayed in the table below. One strategy is to convert patients on Lipitor 20mg, 40mg, and 80mg to
Crestor 5mg, 10mg, and 20mg, respectively and to convert the Lipitor 10mg patients to Pravastatin
40mg. However, the most economical strategy would be to convert all patients currently being
prescribed Lipitor to Crestor.
Since Lipitor has several options, the following table summarizes the data discussed on pages 13 and 14.
Drug and Strength Switch To Source Annual Cost Payor
Lipitor 10mg, 20mg,
40mg, 80mg
Atorvastatin 10mg,
20mg, 40mg, 80mg
50 Plus Pharmacy $2,228.92 Clinic
Lipitor 10mg, 20mg,
40mg, 80mg
Atorvastatin 10mg,
20mg, 40mg, 80mg
Rx Outreach $11,430.00 to
$12,700.00
Clinic
Lipitor 20mg, 40mg,
80mg
Crestor 5mg, 10mg,
20mg
Astra Zeneca PAP $0.00 -------
Lipitor 10mg Pravastatin 40mg Walmart, Target,
Hyvee
$2,200.00 to
$2,640.00
Patient
Lipitor 10mg Pravastatin 40mg 50 Plus Pharmacy *still need to call
for price
Clinic
Lipitor 10mg Pravastatin 40mg Rx Outreach $2,200.00 Clinic
16. 15 | P a g e
Pfizer drug: Neurontin
Number of 90 day fills in 2012: 34
Possible substitute: Gabapentin
There are two options for replacing Neurontin. The clinic can order Gabapentin through either 50 Plus
Pharmacy or Rx Outreach. The annual cost of ordering Gabapentin from 50 Plus Pharmacy will range
between $1,446.65 and $1,822.54 (depending on strength and bottle size ordered) and an additional 34
scripts for the dispensary to fill per year. The annual cost for Rx Outreach will be $4,920.00, but only for
up to 270 tablets (90 days supply). For patients that exceed the maximum 270 tablets per 90 days, the
prices will be higher.
Gabapentin
50 Plus Pharmacy: $1,446.65
Rx Outreach
o 90 days supply: $4,920.00
o Up to 270 tablets
50 Plus Pharmacy: Prices vary depending on strength and bottle size.
Rx Outreach: $25 for 300mg and $45 for 600mg and 800mg
17. 16 | P a g e
Pfizer drug: Norvasc
Number of 90 day fills in 2012: 58
Possible substitute: Amlodipine
To avoid placing financial burden on patients, the clinic can order Amlodipine from 50 Plus Pharmacy,
Auburn Pharmacy, or Rx Outreach. Amlodipine is not available at Walmart, Target, or Hyvee. The
annual cost of ordering Amlodipine from 50 Plus Pharmacy ranges between $136.57 and $156.66
(depending on bottle size ordered) and an additional 58 scripts for the dispensary to fill per year. The
annual cost, if ordering from Auburn Pharmacy will be $2,784.00. At Auburn Pharmacy, the clinic can
forward 90 day prescriptions for the cost of $12 each. If Rx Outreach is utilized, the annual cost would
be $4,640.00. For both of the Auburn Pharmacy and Rx Outreach options, there would be no additional
burden on the dispensary.
Amlodipine
50 Plus Pharmacy: $136.57
Rx Outreach: $4,640.00
Auburn Pharmacy: $2,784.00
50 Plus Pharmacy: Prices vary depending on strength and
bottle size.
Rx Outreach: $20 for 90 days supply and $40 for 180 days
supply
Auburn Pharmacy: $12 for a 90 days supply
18. 17 | P a g e
Pfizer drug: Zoloft
Number of 90 day fills in 2012: 52
Possible substitute: Sertraline
There are two options for replacing Zoloft. The clinic can order Sertraline either from 50 Plus Pharmacy
or Rx Outreach. The annual cost when ordering from 50 Plus Pharmacy will range between $462.83 and
$558.03 (depending on strength and bottle size) and an additional 52 scripts for the dispensary fill per
year. The annual cost for Rx Outreach will be $5,200.00 with no additional burden on the dispensary.
Sertraline
50 Plus Pharmacy: $462.83
Rx Outreach: $5,200.00
50 Plus Pharmacy: Prices vary depending on strength and
bottle size.
Rx Outreach: $25 for a 90 days supply
19. 18 | P a g e
Options for patients to purchase scripts on their own do not exist for Sertraline, but there are some
other anti-depressants that are on discount lists; Citalopram and Fluoxetine. Both of these are available
with Auburn Pharmacy, Walmart, Target, Hyvee, and Rx Outreach. Annual costs for changing to either
Citalopram or Fluoxetine will be:
Rx Outreach:
o Citalopram 10mg, 20mg, 40mg: $4,160.00 (90 days supply)
o Fluoxetine 10mg, 20mg, 40mg: $3,120.00 (90 days supply)
Auburn Pharmacy: About $2,496
o Citalopram 10mg, 20mg, 40mg (90 days supply)
o Fluoxetine 10mg, 20mg (90 days supply)
Walmart, Target, Hyvee: Between $2,080.00 and $2,496.00
o Citalopram 20mg, 40mg
o Fluoxetine 10mg, 20mg, 40mg
o $4 for 30 days supply
o $10 for 90 days supply
20. 19 | P a g e
Conclusion
With this cost analysis for each of the alternative sources, the clinic can make some decisions about
which method will be the most economical. Different scenarios can be mapped out and decisions can
be made upon factors such as: clinic costs, patient costs, and impact on the dispensary. There are two
different scenarios that map out choices across the spectrum. Scenario 1 places all of the cost on the
clinic and scenario 2 places the least amount of cost on the clinic.
Scenario 1 ---50 Plus Pharmacy Only
In scenario 1, if the clinic chooses to provide all medications by ordering from 50 Plus Pharmacy and
having the dispensary fill the extra 506 (90 days supply) prescriptions, the overall impact would be:
Drug Annual Cost
Accupril (Quinapril)/(Lisinopril) $3,442.30/ $1,075.62
Aldactone (Spironolactone) $370.10
Alzulfidine (Sulfasalazine) $32.32
Cardura (Doxazosin) $468.62
Geodon (Ziprasidone) $2,039.04
Glucotrol (Glipizide) $9.60
Glucotrol XL (Glipizide XL, ER) $313.93
Lipitor (Atorvastatin) $2,228.92
Neurontin (Gabapentin) $1,446.65
Norvasc (Amlodipine) $136.57
Zoloft (Sertraline) $462.83
Total Annual Cost $10,950.88/ $8,584.20
The total annual cost for the clinic to order all medications being removed from the Pfizer PAP would be
$10,950.88. The total number of 90 day prescriptions to fill would be 506. Since the data used to tally
this number included all patients that filled these 11 medications, it accounts for the annual count of
506 prescriptions filled. In 2012, the dispensary filled about 1262 prescriptions and the additional 506
prescriptions would lead to an increase in work load of about 40%. Since the dispensary is open only on
Tuesday nights, these additional 506 prescriptions would average out to be an additional 10
prescriptions per week.
If the Quinapril was replaced with Lisinopril, then the clinic could save a significant amount. The annual
cost of Lisinopril is $1,075.62. The new total cost to order all medications from 50 Plus Pharmacy would
be $8,584.20.
If the clinic wanted to avoid placing any financial burden on patients, then scenario 1 would be the
option to choose.
21. 20 | P a g e
Scenario 2 ---Discount drug list for Walmart, Target, and Hyvee + 50 Plus Pharmacy+ Therapeutic
Equivalent Conversions
In scenario 2, the clinic would send prescriptions to Walmart, Target, or Hyvee for the medications that
were available on the discount drug lists and order in the rest of the medications from 50 Plus
Pharmacy. In this scenario, the clinic would also try and convert patients to a therapeutic equivalent or
similar drug category medication to provide the most savings for the clinic. Some of these conversions
include:
Accupril (Quinapril; n=160)---Lisinopril
Lipitor 20mg, 40mg, 80mg (Atorvastatin; n=72)---Crestor
Lipitor 10mg (Atorvastion; n=55)---Pravastatin
Zoloft (Sertraline; n=52)---Citalopram or Fluoxetine
The breakdown of costs is summarized in the table below. The rows highlighted in pink denote what the
patients’ annual costs would be.
Drug Switch To Number of 90 day
prescriptions
Source Annual Cost
Accupril
(Quinapril)
Lisinopril 5mg, 10mg,
20mg
(40mg not available)
160
Walmart, Target,
Hyvee 90 day
supply for $10
$9,520.00
Aldactone
Spironolactone 25mg
(50mg not available)
33
Walmart, Target,
Hyvee 90 day
supply for $10
$1,360.00
Alzulfidine Sulfasalazine 500mg 1 50 Plus Pharmacy $32.32
Cardura
Doxazosin 2mg, 4mg,
8mg
28
Walmart, Target,
Hyvee 90 day
supply for $10
$1,120.00
Geodon Ziprasidone 60mg 4 50 Plus Pharmacy $2,039.04
Glucotrol Glipizide 10mg 1
Walmart, Target,
Hyvee 90 day
supply for $10
$40.00
Glucotrol XL Glipizide XL, ER 8 50 Plus Pharmacy $313.93
Lipitor 10mg Pravastatin 40mg 55
Walmart, Target,
Hyvee 90 day
supply for $10
$2,200.00
Lipitor 20mg,
40mg, 80mg
Crestor 5mg, 10mg,
20mg
72 AstraZeneca PAP $0.00
Neurontin
Gabapentin 300mg,
600mg, 800mg
34 50 Plus Pharmacy $1,446.65
Norvasc
Amlodipine 2.5mg
5mg, 10mg
58 50 Plus Pharmacy $136.57
Zoloft
Citalopram or
Fluoxetine
52
Walmart, Target,
Hyvee 90 day
supply for $10
$2,080.00
22. 21 | P a g e
The total costs for the clinic in scenario 2 will be $3,968.51 and an additional 105 prescriptions for the
dispensary to fill per year. This averages out to an extra 2 prescriptions to fill per week. The financial
burden for the patients adds up to $16,320 (annual cost). Scenario 2 would save the clinic the most
money, but potentially place a large burden on patients.
Other sources of replacing Pfizer PAP drugs that were not discussed in scenario 1 or 2 include Auburn
Pharmacy and Rx Outreach. An advantage to using Auburn Pharmacy is that patients may have easier
access and more convenient times to acquire their prescriptions. The only drug that was on Auburn’s
discount list ($12 for a 90 day supply) that was not on Walmart, Target, or Hyvees’ lists is Amlodipine
($2,784.00). However, it was not included in the scenarios because it is more economical to order the
Amlodipine from 50 Plus pharmacy ($136.57). To see a full comparison picture of Auburn Pharmacy
versus 50 Plus Pharmacy, please see the table below:
Drug 50 Plus Pharmacy Auburn Pharmacy
Accupril (Quinapril) $3,442.30 $7,680.00 (must switch to
Lisinopril, because Quinapril
not available)
Aldactone (Spironolactone) $370.10 $1,632.00
Alzulfidine (Sulfasalazine) $32.32 ***Not available
Cardura (Doxazosin) $468.62 $1,344.00
Geodon (Ziprasidone) $2,039.04 ***Not Available
Glucotrol (Glipizide) $9.60 $48.00
Glucotrol XL (Glipizide XL, ER) $313.93 ***Not Available
Lipitor (Atorvastatin) $2,228.92 ***Not Available
Neurontin (Gabapentin) $1,446.65 ***Not Available
Norvasc (Amlodipine) $136.57 $2,784.00
Zoloft (Sertraline) $462.83 ***Not Available
The same pattern occurred with medications available through Rx Outreach. The prices from 50 Plus
Pharmacy were more economical.
Drug 50 Plus Pharmacy Rx Outreach
Accupril (Quinapril) $3,442.30 $5,760.00 (switch to
Lisinopril, Quinapril too
expensive)
Aldactone (Spironolactone) $370.10 $1,360 .00
Alzulfidine (Sulfasalazine) $32.32 $190.00
Cardura (Doxazosin) $468.62 $1,120.00
Geodon (Ziprasidone) $2,039.04 ***Not Available
Glucotrol (Glipizide) $9.60 $40.00
Glucotrol XL (Glipizide XL, ER) $313.93 $1,040.00
Lipitor (Atorvastatin) $2,228.92 $11,430.00
Neurontin (Gabapentin) $1,446.65 $4,920.00
Norvasc (Amlodipine) $136.57 $4,640.00
Zoloft (Sertraline) $462.83 $5,200.00
23. 22 | P a g e
References
1
Rx Outreach. Website. http://www.rxoutreach.org/medications/
2
Auburn Pharmacy Discount Drug List. Pdf document.
http://www.auburnpharmacies.com/adcard_files/generic_June2013.pdf
3
Walmart Discount Drug List. Pdf document.
http://i.walmartimages.com/i/if/hmp/fusion/customer_list.pdf
4
Target Discount Drug List. Pdf document.
http://static.targetimg1.com/pharmacy/pdf/06272013-RxGenerics_Condition.pdf
5
Hyvee Discount Drug List. Pdf document. http://www.hy-vee.com/webres/File/400list_category90.pdf
6
Therapeutic Equivalent Conversion Chart from Pharmacist Letter. Subscription required to view.
http://pharmacistsletter.therapeuticresearch.com/pl/ArticleDD.aspx?nidchk=1&cs=student&s=P
L&pt=2&fpt=56&dd=271101&pb=PL&segment=3732
24. 23 | P a g e
http://pharmacistsletter.therapeuticresearch.com/pl/ArticleDD.aspx?nidchk=1&cs=student&s=PL&pt=2&fpt=56&dd=271101&pb=PL&segment=3732&AspxAutoDetect
CookieSupport=16
Appendix
Table 1. Source from Pharmacist Letter6
