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Patient Alert: How to Get the Best Price on New Generic Plavix
Survey by Angioplasty.Org shows prices range from 35 to $6 per pill;
Are you paying too much for your antiplatelet medication?
Plavix and heart stent

(Note: A newer version of this article appears here, updated as of October 4, 2012) The financial cost of Plavix has been a problem for many stent patients who are prescribed this expensive brand-name antiplatelet drug. The new generic Plavix (clopidogrel) can be purchased for a fraction of the price.

Read on to learn more, including a price comparison that shows you where to shop, a look at the role of online patient communities, breaking news about Plavix co-pay discounts, and more resources to help you get the most affordable antiplatelet drugs.

Generic Plavix Hits the Market: Why it Matters for Patients
On May 17, 2012, patent protection ended for Plavix, the best-selling antiplatelet drug made by Bristol-Myers Squibb / Sanofi-Aventis. Being able to get lower-cost generic Plavix, called clopidogrel, is a huge boon for stent patients, especially those who lack prescription drug insurance coverage. But first patients have to find a pharmacy offering a good price.

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Plavix (clopidogrel) is prescribed for a year or more after placement of a heart stent in order to prevent the stent from clotting up and causing a heart attack. Called "stent thrombosis", this complication, although very infrequent, is fatal more than a third of the time.

In 2010, worldwide sales of Plavix topped $6 billion (yes...billion!). For a typical stent patient, one 75mg tablet of brand-name Plavix a day cost more than $210 a month. Those with drug-eluting stents (80% or more of patients) generally must take Plavix for a year minimum. So, until now, the required medication often cost more than the stent itself.

Generic Plavix Price Comparison: Cost Per Pill
With the expiration of the Plavix patent, generic clopidogrel is being manufactured by several companies. After a medication goes generic, it often takes months for production and competition to build to the point where discounts are widely available.

As of May 2012, prices are all over the map (1). The hope has been that generic Plavix will generally drop to $1 a pill. But as of May 29, 2012 both CVS and Walgreens were offering generic Plavix at around $6 a pill, only pennies less than they charged for brand-name Plavix just a few weeks ago (it seems that the price for brand-name Plavix has risen since it went generic).

WalMart/Sam's Club is offering generic clopidogrel in their in-store pharmacies for approximately $1.46 per pill.

But the price winner, as of late May 2012, is the major online / brick and mortar pharmacy Costco. Their cash price averages $0.35 a pill, or only $10 a month!

Online Patient Communities: Sharing Antiplatelet Deals
Angioplasty.Org's popular Patient Forum gets over 40,000 page views a month and the Discussion Topic on Financial Assistance for Plavix is one of the most active message boards. Forum members are urging patients to join the conversation and post the prices they are getting for generic clopidogrel so that others can find sources to get the best deal on their medications.

New Plavix Co-Pay Discounts: Competing with Generic Antiplatelet Drugs
Anticipating the switch to generics, Bristol-Myers Squibb is offering a special co-pay discount card program for the remainder of 2012. It guarantees that individuals with commercial insurance, or those who pay cash, will not have to spend more than $37 a month for Plavix, offering to cover up to $176.50 in savings.

Here's a link to get the Plavix Co-Pay Discount Card.

Not All Stent Patients Benefit from Plavix/Clopidogrel: Should You Be on Effient or Brilinta Instead?
Some stent patients are prescribed alternatives to Plavix. Studies show that more than 20% of the population does not metabolize clopidogrel completely -- these "non-responder" patients may be treated with increased dosages, or possibly a different antiplatelet drug, such as Effient (prasugrel) or Brilinta (ticagrelor) which do not need to be metabolized first.

There is some concern that an unintended effect from the reduction in price for Plavix/clopidogrel could be that insurance companies will balk at paying for these other brand-name antiplatelet medications in patients who do not do well on Plavix. Hopefully this problem won't occur, because heart patients who do not respond to Plavix should have equally affordable lifesaving medications available to them.

You can read more about patients who do not respond to clopidogrel and how they can be tested and treated in Angioplasty.Org's interview with Dr. Eric Topol.

(1) Per pill prices are based on the cash price for 90 tablets, surveyed on May 29, 2012

Reported by Deborah Shaw, Patient Education Editor, May 30, 2012