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Patient Alert: How to Get the Best Price on New Generic Plavix (updated Jan 2017)
Survey by Angioplasty.Org shows prices range from 21 to almost $7 per pill;
Are you paying too much for your antiplatelet medication?
Plavix and heart stent

The financial cost of Plavix has been a problem for many stent patients who are prescribed this expensive brand-name antiplatelet drug. 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.

Back in May 2012, Angioplasty.Org surveyed a few large pharmacy providers in the U.S. and found that the cash prices for generic clopidogrel (75 mg in a quantity of 90) were all over the map. 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 earlier (it seems that the price for brand-name Plavix has risen since it went generic). WalMart/Sam's Club was offering generic clopidogrel in their in-store pharmacies for approximately $1.46 per pill.

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

Price Update as of October 2012: Cost Per Pill
When we queried the large pharmacy providers five months ago, we were told that after a few months competition would set in and prices should drop significantly. Our survey on October 4, 2012 showed only a very small dip in prices. So much for free market competition!

For 75 mg generic clopidogrel, both CVS and Walgreens were quoting slightly more than $5.50 a pill, only an 8% drop from May. WalMart/Sam's Club was offering generic clopidogrel in their in-store pharmacies for approximately $1.80 per pill; $1.50 if you ordered from their centralized home delivery.

But once again, the price winner was Costco. Their cash price is now $0.32 a pill, or under $10 a month!

Worthy of note: Brand-name Plavix is now selling for $7.50/pill at Walgreen's, a significant rise from the pre-generic era. In fact, Walgreen's current generic price of $5.50 is slightly more than the brand-name price was before the drug went generic.

Price Update as of January 2017: Cost Per Pill
Since clopidogrel went generic, the cost of brand-name Plavix has gone out-of-sight. Even the deep discounted Costco pharmacy is selling Plavix for almost $7/pill. But their price on generic clopidogrel is the lowest anywhere: 21¢. While you need to be a member of Costco to buy most merchandise at Costco, you DO NOT NEED TO BE A MEMBER to purchase items from the pharmacy.

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
(Editor's note: as of February 2013, it seems that the link below no longer goes to a discount card and that Bristol-Myers Squibb is no longer offering financial assistance for Plavix.)

Anticipating the switch to generics, Bristol-Myers Squibb has been offering a special co-pay discount card program. It guarantees that individuals with commercial insurance, or those who pay cash, will not have to spend more than $37 a month for brand-name Plavix, and the company is offering to cover up to $176.50 a month in savings.

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

Worthy of note: Several patients have posted to Angioplasty.Org's Discussion Topic on Financial Assistance for Plavix that they have had difficulty getting their pharmacy to honor the Bristol-Myers Squibb discount card -- and these were drugstores listed as "participating." Ultimately the patients succeeded, but their experience only emphasizes that it is necessary to be an educated consumer/patient in today's healthcare environment.

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.

Reported by Deborah Shaw, Patient Education Editor, May 30, 2012; updated October 4, 2012, February 18, 2013, January 7, 2017