We’re nearing the end of the year, and many people are already in open enrollment for next year’s health coverage, which means it is a great time to plan ahead for your 2010 drug expenditures. No, you can’t know every medication you are going to need, but if you are on a popular, patented maintenance drug such as Lipitor or Cozaar, you’ll be pleased to hear that their patents are expiring in 2010, opening the field for more-affordable U.S. generic versions.

In the meantime, as you do your research, you will see that many are already available as generics, manufactured outside of the U.S. There is usually a considerable cost savings.

Here are all the details of some of the highest-profile drugs that have expiring patents as of the end of 2009, or during 2010 — and how and where to get the generic versions.

ARICEPT (donepezil). Pfizer makes the acetylcholinesterase inhibitor Aricept for the treatment of Alzheimer’s disease. Aricept is scheduled to lose patent protection in the U.S. in 2010, but generic versions are already available.

COZAAR (losartan). Merck’s Cozaar is an angiotensin II receptor antagonist, used to treat hypertension. Cozaar’s patent protection in the U.S. will expire in 2010. In the meantime, generic losartan is available here.

LEVAQUIN (levofloxacin). Johnson & Johnson’s antibiotic drug Levaquin will outlive its patent protection in 2010. However, until that time, you can purchase generic levofloxacin here.

LIPITOR (atorvastatin). Pfizer has the best-selling drug in the world in Lipitor, which treats high cholesterol. In the US, the basic patent for Lipitor expires in March 2010, while the second patent covering the calcium salt of atorvastatin expires in June 2011. It is not yet clear exactly which date will see widespread availability of generic Lipitor in the U.S., but it is coming. In the meantime, generic atorvastatin is available here.

XENICAL (orlistat). Roche’s Xenical is an obesity treatment that prevents the digestive system from absorbing fats. Its patent expires in December of this year.  (Note: In some countries, including the U.S., orlistat is available over-the-counter as GlaxoSmithKline’s Alli.)

VALTREX (valacyclovir). GlaxoSmithKline’s Valtrex is a treatment for herpes simplex and herpes zoster (shingles). Valacyclovir was recently approved for generic production, and so generic versions will be on the U.S. market by the end of 2009. As of this writing, generic valacyclovir is available here.

If you’re interested in the business ramifications for the pharmaceutical companies, CNN ran a good article on the topic, and so did Chemistry World.

Enjoy using EDrugSearch.com to knowledgeably plan your medication choices for the coming year.

Check it out and start saving on your prescription drugs now!

We wrote recently about the rapidly growing business of mail-order pharmacies run by the pharmacy benefit managers (PBM) who work with employer-based insurance providers.

It’s been a trend with no small hint of irony. You see, when Canadian mail-order pharmacies came on the scene in the ’90s, representatives of Big Insurance and Big Pharma trashed the whole idea of the mail-order pharmacy. They said it was unwise — even dangerous — to order drugs without having face-to-face contact with your pharmacist. They said your relationship with your pharmacist was just as important as the one you have with your doctor.

All that would be lost, they said, if you ordered from an online pharmacy. Of course, now that they’ve figured out how to make a buck off of the idea, they love it.

And now, Big Insurance is moving toward a day when you may actually be forced to order your drugs online or through mail-order — whether you like it or not.

As U.S News reports:

Express Scripts, one of the nation’s largest pharmacy benefit managers, has developed a program [called] Select Home Delivery [that] automatically enrolls employees in the home delivery program unless they specifically opt out of it …

That’s right. If your employer’s PBM is Express Scripts, and they sign up for Select Home Delivery, mail-order will be the default option for all employees.

Mark my words here; this is the first of several shoes to drop. Up next:

1. Soon, all other PBMs will offer the same program.
2. Then, one PBM will come up with a program that makes participation in the mail-order program mandatory in order for employees to receive coverage — in the name of employer cost savings.
3. That will become the dominant model for employer-based prescription drug insurance.

Now, I haven’t factored in the uproar that this would cause with the Wal-Marts, Rite Aids and the like. Some kind of accommodation will probably have to be reached to make all the big-money players happy.

And of course, consumers won’t like it, because no one likes having their choices taken away. But how much power do consumers have these days in the face of Big Insurance and Big Pharma, anyway?

When you listen to Express Scripts tout the benefits of Select Home Delivery, you know it’s only the beginning:

“Moving from retail to home delivery may be the most powerful intervention we have today to improve therapy adherence,” says Bob Nease, chief scientist for Express Scripts, referring to patients who follow their prescribed drug regimens. Home delivery also saves patients money, typically up to a third of the prescription cost for a 90-day supply.

So far, about two dozen companies have signed up for the Select Home Delivery program. Home improvement retailer Lowe’s has seen the percentage of prescriptions filled through home delivery rise from about 14 percent to 40 percent since the company signed on, says Nease.

As you know, we at eDrugSearch.com are big fans of mail-order pharmacies. We were fans of mail-order pharmacies long before the insurance companies.

We know that mail-order pharmacies save healthcare consumers money. And we’re glad that millions of consumers will learn through programs like Select Home Delivery that they need not be scared of ordering drugs through the mail.

That will be especially important should these workers lose their jobs or prescription drug coverage — and realize they can pay up to 80 percent less on their medications by ordering through eDrugSearch.com’s network of licensed mail-order pharmacies.

All that being said, we continue to find the arrogance and hypocrisy of the big health insurance companies astounding.

Rite Aid is a $24 billion company operating more than 5,000 drugstores in 31 states, making it the third-largest pharmacy chain in the United States. But unless this overpriced retailer receives some bailout money from heaven (’cause it’s sure not coming from Washington), the year 2009 may be its last.

Motley Fool has just put it on its list of 15 companies that might not survive the year. Says the Fool:

Rite Aid. (Ticker symbol: RAD; about 100,000 employees; 1-year stock-price decline: 92%). This drugstore chain tried to boost its performance by acquiring competitors Brooks and Eckerd in 2007. But there have been some nasty side effects, like a huge debt load that makes it the most leveraged drugstore chain in the U.S., according to Zacks Equity Research. That big retail investment came just as megadiscounter Wal-Mart was starting to sell prescription drugs, and consumers were starting to cut bank on spending. Management has twice lowered its outlook for 2009. Prognosis: Mounting losses, with no turnaround in sight.

Rite Aid’s story, full of waste and mismanagement, is a classic illustration of why Americans save so much money through online and mail-order pharmacies. Whether these pharmacies are based in the United States or Canada, they require a fraction of the overhead of a big chain pharmacy — particularly one as poorly run as Rite Aid.

Rite Aid has been in trouble as far back as 1999, when it was busted by the news media (and investigated by state regulators) for questionable business practices like selling date-sensitive products well past their due dates. Rite Aid also had a doozy of an accounting scandal that led to jail time for several top ranking execs, including CEO Martin Grass.

Like many bloated Fortune 500 corporations, Rite Aid tried to put lipstick on the pig by acquiring competitors like Eckerd. It’s a quick way to boost your top line to impress your stockholders without actually doing anything intelligent to help your customers. Rite Aid went deeply into debt in the process, and now they’re on death’s door.

In addition to its own incompetence, Rite Aid has been hurt badly by the trend toward mail-order pharmacies and by Wal-Mart’s $4 prescription drug plan, which savvier retailers (including finally CVS late last year) have copied.

In its own backward way, Rite Aid has been trying to catch up with its lower-cost competitors, but it’s almost undoubtedly too little, too late.

Rite Aid does frequently offer short-term promotions for consumers who transfer their prescriptions (for example, If you transfer two prescriptions to Rite Aid, you receive a $25 gift card for each — a $50 value.) However, their Rx Savings Card only entitles you to an $8.99 price for select generics — more than twice as much as Wal-mart and many others now charge.

That’s the best you’ve got? Good luck with that, Rite Aid. We’ll see you in the business obituary section.

Obviously, Big Pharma doesn’t want that happening here — which may help to explain why Pfizer has funded a new Rand Corporation study saying that lowering drug prices through price controls would have horrific consequences for Americans.

How horrific? It would actually reduce the length of your life!

As Reuters reports:

Imposing European-style price controls on prescription drugs in the United States would result in modest cost savings that would be more than offset by shortened life spans as the pace of drug innovation slows, U.S. researchers said on Tuesday. They said lowering insurance co-payments would be a better way of attacking the problem of rising prescription drug prices in the United States, which pays more per capita for pharmaceuticals than any other nation.

“We found policies that regulate the prices of drugs could result in modest savings for consumers, in the best cases on the order of $5,000 to $10,000 per person over a lifetime,” said Darius Lakdawalla of the nonprofit Rand Corporation, who worked on two studies appearing in a special report on drug pricing in the journal Health Affairs.

“But in many other cases, those policies resulted in very substantial losses to consumers in the form of reduced life expectancy and those would be worth tens of thousands of dollars”…

They said introducing price regulations into a largely unregulated market like the United States would result in less investment in developing life-saving drugs, which in the long run would reduce the life expectancy of Americans.

I found it interesting that Pfizer’s funding of this little project was not mentioned until the 11th paragraph of the story.

I also found it interesting that there is no mention of the fact that in most European countries with prescription drug price controls, life spans are longer than in the United States.

Way to keep your eye on the ball, Reuters.

A final point to ponder: Rand says its study is objective. It just happens to put the burden of healthcare price reform on Big Insurance rather than Big Pharma, by saying the solution is to find a way to lower drug co-pays.

Do you think if the study had been funded by Humana or some other big insurance provider, Rand’s report might say something different?

People may care as much about the cost of prescription drugs these days as they do about getting a good deal on a car. They’re up against the breathtaking drug costs a lot more often. At least they can talk to the car salesmen. Even if we’re not good at numbers, we probably get a better deal when we haggle. With cars, it’s accepted as the American way.

So, what if we could bargain a little on the cholesterol meds? And what if the state came onto the showroom floor (as it were) to strengthen our hand? Couldn’t hurt. A bill that would have allowed states to intervene on behalf of low-income consumers was offered five years ago by then-Sen. Paul D. Wellstone, Democrat of Minnesota. When he was killed in a plane crash, his bill effectively died with him…

Now, though, a measure similar to the one proposed by Senator Wellstone … is pending in the House of Representatives. Maryland’s Rep. Chris Van Hollen is the sponsor. His bill would allow Maryland and all the other states to negotiate reduced prescription drug prices for low-income families – those earning less than three times the federal poverty level of $20,650 for a family of four. Patients would get discount cards for use at the drugstore…

“This is an issue that we can bring a majority of members together on,” Mr. Van Hollen said. “The power of that drug lobby has been diminished since we got a new Democratic majority in Congress.”

It’s a worthy effort, to be sure. But the bill is another palliative, a reflection of the failure of government and industry to find a comprehensive way to contain medical costs, provide insurance for all and keep drug bills from rivaling the monthly car payment.

I’m sure tens of millions of Americans wouldn’t mind a “palliative” — any relief would be better than none.

The real issue is that Big Pharma will soon be swatting Van Hollen like a fly.

The fact is, drugs purchased from licensed Canadian pharmacies generally come from the same U.S. drug manufacturers that ship them to American pharmacies.  Legitimate pharmacies in the U.S. and Canada rarely, if ever, receive counterfeit medications.

In 2003 the U.S. House of Representatives approved importing prescription medications from Canada by a vote of 243 to 186.  The U.S. Senate has voted similarly.  Many state and local governments are currently purchasing Canadian medications for their employees. These actions by government officials speak volumes about the quality of drugs coming in from across the border.

Canadians drugs from licensed pharmacies are safe — period.  So, why has the Bush Administration opposed legalization?  The pharmaceutical lobby has enormous influence in Washington — and they are worried about their profits.  Millions of Americans are already buying their prescription drugs from Canada. Big drug companies such as Pfizer and GlaxoSmithKline have even gone so far as to refuse to sell to Canadian pharmacies that ship medications back to the United States. 

Does this sound like a safety concern to you?