According to a new analysis based on data from the Colorado All Payer Claims Database (CO APCD), Colorado is spending millions of dollars a year on two drugs – Vimovo and Duexis – which have alternative over-the-counter options available at a fraction of the price.

Patients suffering from chronic pain and conditions like arthritis are likely to receive prescriptions for high dosage anti-inflammatory drugs to help manage their pain. Use of these drugs, also known as NSAIDs (nonsteroidal anti-inflammatory drugs), is growing as clinicians explore non-opioid treatment options. However, taking NSAIDs alone can lead to severe gastrointestinal issues; therefore, many providers recommend their patients take an acid-reflux medication in addition to the pain medication.

To relieve some of the burden on patients who need to take multiple medications, in 2010 and 2011, a pharmaceutical company launched two new combination drugs, Vimovo and Duexis, which blend two medications available separately over-the-counter. Vimovo is essentially Aleve and Nexium combined, and Duexis is the equivalent of an Advil and a Pepcid in one pill.

These combination pills have the potential to increase patient medication adherence, but they come with a hefty price tag. According to 2016 data in the CO APCD, Duexis costs approximately $1,400 for a 30-day supply, while Vimovo is around $1,500 for the same timeframe. Over-the-counter equivalents for both drugs are available for $40-$60 per month.

Not considering dosage or rebates the patient or health plan may have received, the total paid for both of these drugs by patients, Medicaid, and commercial health plans from 2012-2016 was over $24 million dollars.

During the same four years, over 30,500 prescriptions were filled, and the average total cost per prescription went up over 2,000 percent. Since 2012, prescriptions for Vimovo and Duexis have been steadily declining among commercially insured patients, but generally increased for Medicaid patients until peaking in 2015 and dropping in 2016.

CO APCD data also indicates that while a little more than half of all counties across Colorado have residents filling both prescriptions, some counties have higher rates of patients receiving the medications than others. The top five counties for prescription fulfillments differ when looking at commercially insured patients and those with Medicaid. Both rural and urban counties seem to be impacted across both payer types, and Jefferson county ranked highest in the rates of fulfillment for both Duexis and Vimovo prescriptions for the Medicaid population.

This analysis highlights a potential cost-savings opportunity for Colorado where targeted education and interventions could support patient, provider and health payer decision-making,” said Ana English, CIVHC President and CEO. “These two drugs only represent a fraction of overall pharmacy spending in Colorado, yet this data demonstrates the power of transparency in uncovering opportunities to reduce the cost of health care in Colorado.”

According to the Cost of Care interactive reports available on CIVHC’s website, drug costs are clearly one of the areas driving spending, with annual pharmacy costs per person per year going up 27 percent since 2012 . This new Spot Analysis demonstrates only one of many possible drill-down analyses that can be done with the CO APCD to help inform patients and other stakeholders looking for ways to lower pharmacy costs and improve the health of Coloradans.

  • Download the Vimovo/Duexis Spot Analysis

Have a suggestion for another pharmaceutical analysis? Please let us know at ColoradoAPCD@civhc.org.

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