John has a diagnosis of heart failure and has to take 4 new medications. You receive the prescriptions and realize it has been written for brand. Before you suggest dispensing generic, you check out the patient's profile to see if they are near reaching catastrophic coverage because you know they have other medications for type 2 diabetes and depression. You see that the patient is in the donut hole and decide to calculate out his costs for these drugs if you fill them with brand or generic.

You know that in the coverage gap, 95% of the price (70% manufacturer discount and 25% what the patient pays) of brand name drugs will be applied to get John out of the gap. Generics are 25/75% cost sharing patient/plan. The dispensing fee is $2 for all drugs. Calculate the following:

Vasotec 2.5 mg 30 day supply: $120 VS. Enalapril 2.5 mg 30 day supply: $14.00

Digitek 125 mg 30 day supply: $60 VS. Digoxin 125 mg 30 day supply: $5.00

Toprol 25 mg 30 day supply: $90 VS. Metoprolol 25mg 30 day supply: $10.00

Lasix 20 mg 30 day supply: $40 VS. Furosemide 20 mg 30 day supply: $5.00

What will John's out-of-pocket cost be for all brand name drugs? What is paid by his PDP?

What will John's out-of-pocket cost be for all generic drugs? What is paid by his PDP?

Answer rating: 100% (QA)

To calculate Johns outofpocket cost and what is paid by his PDP for both brand name and generic drug... View the full answer