If you're already taking Zocor, switching to the generic is a relatively straightforward clinical decision. Generics typically work just as well as brand-name drugs, doctors say.
For patients on Lipitor, the answer is a bit murkier. "It's very reasonable for many patients to be considering making the switch if they can still get comparable results," says Roger Blumenthal, director of the Johns Hopkins Ciccarone Preventive Cardiology Center. However, he says, "for some people, one medicine seems to work a little bit better than another."
Lipitor is considered more powerful than Zocor: The general understanding is that a 10-milligram pill of Lipitor achieves roughly the same effect as a 20- or 40-milligram pill of Zocor, cardiologists say. So patients who need relatively high doses of Lipitor are less likely to achieve their cholesterol targets with brand-name or generic Zocor, says Dr. Blumenthal. For many patients with mild or moderate cholesterol problems, Zocor or its generic can be a fine choice, he says.
AstraZeneca PLC's Crestor, another cholesterol-lowering drug, is considered more powerful than Lipitor. Patients who need Crestor to achieve their cholesterol targets have low odds of similar success with brand-name or generic Zocor, says Dr. Blumenthal.
Robert Rosenson, a cardiologist and professor at Northwestern University's medical school, points out that in recent years cholesterol-lowering guidelines have become more aggressive for high-risk patients. "By moving to more powerful agents, the physician can help a patient achieve their LDL-cholesterol target more effectively and also at a lower dosage of the medication," he says.
What's best for you may be impacted by other drugs you're taking. For instance, patients taking amiodarone, for abnormal heart rhythms, or verapamil, for abnormal heart rhythms or high blood pressure, are cautioned to avoid Zocor or its generic at higher doses because of potential side effects. Individual patients sometimes also may experience side effects with one cholesterol-lowering drug that they avoid with another.
Consult with your doctor before switching. To gauge whether you're still achieving your target, your doctor may want to check on your progress several weeks after you've made a change.
Switching to Save Money
If you're making a switch to save money, make sure you'll actually save money. While generics typically cost less than brand-name drugs, it's not a slam dunk that you'll save with generic Zocor right now.
When a brand-name drug loses patent protection, a generic manufacturer may be granted a six-month period in which it can sell copycat versions when most others can't. (The original maker of the drug can also sell the generic, either directly or by arrangement with another generics maker.) The result: Prices don't fall as far during that period as they do once other competitors are allowed to enter the market.
Certain health-insurance companies have decided that it doesn't make sense to push their patients to generic Zocor in those first six months. UnitedHealthcare says it struck a deal with Merck for a cut-rate price on Zocor and put it on the first "tier" of its list of covered drugs, or formulary, for its commercial plans. That means patients on those plans will pay the lowest co-payment for brand-name Zocor. Lipitor is on UnitedHealthcare's second tier, and generic Zocor is on the third.
Blue Shield of California has put brand-name Zocor on its first tier and has said it won't reimburse its commercial members (as opposed to those on government programs such as Medicare) for the generic at all. (See this WSJ article2 about the insurers' decisions.)
If you're paying retail prices for drugs, you're not getting the benefit of an insurer's negotiating power. On drugstore.com3, generic Zocor, called simvastatin, already costs less than brand-name Zocor. But the generic price still isn't that cheap. Ninety 20-milligram tablets of Zocor were listed at $399.97, compared with $353.95 for simvastatin.
The landscape is likely to change when the six-month period ends in late December. Around that time, UnitedHealthcare expects to put the generic on its first tier and brand-name Zocor on its third. Blue Shield of California expects to put the generic on the first tier and brand-name Zocor on the second, with Lipitor remaining on the third. Retail prices of generic Zocor are likely to drop as well.
Bottom line: Before making a switch, do some price checking, either with your insurer or your pharmacy, to make sure it would be worth it.
