Industry awaits launch of generic DuoNeb

Sunday, July 8, 2007

YARMOUTH, Maine – With the first of several generic versions of DuoNeb projected to launch this month, nebulizer medication providers expect downward pressure on reimbursements over the next several quarters.

First in line with a generic is Princeton, N.J.-based Sandoz. At press time, the drug-maker hadn’t released a price or a launch date for the drug.

DuoNeb is a compound of ipratropium and albuterol, eliminating the need for patients to mix treatments on their own. Medicare currently reimburses the compound at $1.11 per dose and ipratropium at 19 cents. Albuterol recently shot from 20 cents per dose to $1.31.

The generic will be billed under the same HCPCS code as DuoNeb (J7620) and receive the same reimbursement.

But without knowing what it will cost to provide the generic, “we can’t tell if it will be more profitable than DuoNeb,” said Sam Jarcynski, president of Stat Rx in St. Petersburg, Fla.

Generics offer a double-edged sword for providers. If the generic has a lower acquisition cost for providers than DuoNeb, as some industry watchers suspect, the drug will have greater short-term profitability; over time, however, it will depress the ASP for DuoNeb and its generic versions, they say.

“The ASP plus 6% model is self-defeating for the aggressive purchaser,” said Wayne Vega, a consultant with Acadiana, La.-based Stat Vial.

Market considerations aside, a generic version of DuoNeb would offer patients who can’t afford brand-name drugs, safer and more effective treatment options, said Tom Ryan CEO of Farmingdale, N.Y.-based Homecare Concepts.

“If we have to have these patients mix ipratropium and albuterol on their own, that’s not a good thing,” he said. “It leads to poor compliance and to potential misdosing.”