Fosamax generic...

Implications: It is important to understand the generic implications when it comes to drug product olacement on the formulary.

Analysis: I disagree with the previous analysis.

As soon as a generic come out, it is placed in tier 1 and the brand alternative is quickly placed in the highest tier or not covered at all.

As the director of clinical affairs for a PBM, I placed the generic Fosamax in tier 1 immediately. I placed Fosamax brand in tier 3 immediately.
I moved Actonel and Boniva to tier 2 now, and in 3-6 months will probably place Actonel and Boniva in tier 3.

With regards to profitability, I will MAC generic Fosamax (or another branded drug) when 3 manufacturers of the generic are available in the marketplace. This includes "authorized" generics too.

If a PBM offers full transparency, then the savings will be passed along to the client, and not kept by the PBM. It depends how the PBM contract was negotiated and what it says with the client.