A pharmaceutical story

About 2 years ago, the health insurance that Duke University provides to employees instituted a mandatory policy that you had to use a mail order pharmacy for recurring medicines, or pay a very large penalty (on the order of $100/prescription). So, I switched the one pharmaceutical I take to this service (Fexophenadine 180mg/once per day [generic for Allegra, a seasonal allergy medicine]). I could obtain a 90 day supply of Fexofenadine for $20 via mail order under this year’s benefit structure.

When I went to fill this prescription a few weeks ago, it was denied because Allegra is now available as an over-the-counter medicine. The other day I went and bought a 90 day supply of the medication, but could only find name-brand Allegra. I bought it from Sam’s Club and it cost $32.50, a great deal more than the generic did as a prescription medicine (found OTC Allegra at several other places for a higher price). I did not find generic Fexofenadine 180/mg per day anywhere.

Is this unusual? Was it just Allegra brand name that is available over the counter? Is it typical for the price of newly-over-the-counter meds to be higher than their prescription generic price under insurance? Or does this just mean that Duke has very nice benefits? Obviously the mail order company will receive volume discounts. Will the generic brands also sell over the counter? Can they?

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