Vimovo – Give Me a Break

Yesterday I heard about Vimovo, a new product marketed by AstraZenica for the treatment of osteoarthritis.  It’s another in the latest rage in drugs, a combination product.  The drug is really just a naproxen pill wrapped in a layer of Nexium. I have to say the artist’s rendition is pretty enticing. Naproxen is a typical non-steroidal anti-inflammatory medication sold as an inexpensive generic over the counter and prescription medication.  By prescription it’s available at the 500 mg twice daily dosing at the discount pharmacies for $4./ month.  Nexium is a marketing miracle that I wrote about earlier, the second grossing sales drug in America.  It is the L-isomer of omeprazole, dosed at twice the typical dose of omeprazole.  Not surprisingly, since this makes Nexium 40 mg roughly equal to omeprazole (branded Prilosec) 80 mg it may work slightly faster than the typical omeprazole 20 mg.  Still since generic  omeprazole at 40 mg dosing costs $39.61/ 90 pills at Costco, and Nexium costs $565.97/ 90 pills at Costco or about 14.2x as much per dose, it’s incredible that so many physicians prescribe Nexium and that so many patients use Nexium.  It’s  a byproduct of our system of third party payment and marketing by big pharma.

Now AstraZenica has come out with Vimovo, which is available in 2 doses, either 375 or 500 mg of naproxen wrapped in 20 mg of Nexium.  This works by allowing the Nexium to be dissolved and absorbed first, neutralizing the stomach acid and thereby reducing the chances of getting an ulcer from the naproxen.  It seems to work pretty well, and the studies compared Viomvo to naproxen alone.  This should come as no surprise to physicians who have been using PPIs to reduce the GI upset of NSAIDs for years.

Not surprisingly there was no study comparing taking a generic inexpensive drug like omeprazole 40 mg a half hour before eating, and taking the naproxen with the meal twice daily.  There is little doubt in my mind that this would be equally effective, and it certainly would cost about 7% as much.

When talking to the drug reps, or looking at the AstraZenica web site it looks like Vimovo only costs $10./ month.  This is another of the drug discount coupons tricks of pharma.  They guarantee that Vimovo will not cost you more than $10 total out of pocket cost per month.  They can do this knowing that most patients will have health insurance which will cover the medication except for a top tier copay of maybe $50./ month.  In this scenario the insurance pays the bulk of the cost of the Vimovo, the company reimburses the pharmacy for the remainder of the copay, and the patient pays $10.  AstraZenica knows that physicians are not going to have time or energy to prescribe the Vimovo only to the uninsured patients and make them essentially give the medication out at a real cost of $10./ month.   The effect of this drug is going to be to add one more expensive drug to the market and to drive up health care costs if physicians actually prescribe Vimovo.

The best thing about this medication is that it has such an obscure name that I’ll never even remember it exists, although I will try so I can prescribe it to the few uninsured patients I have and give them the coupons to reduce the profits of this bogus marketing effort.  I say reduce, because I have little doubt that the company actually makes a profit at $10./ 30 pills.  The cost is of marketing and sales of this product that adds very little to our treatment ability.

28 Responses to Vimovo – Give Me a Break

  1. Toni Brooks says:

    I have been taking Vimovo for 18 months and paying point of sale $119 for 60 yesterday I went to have it filled and it was $821 for 60! Called BCBS and was told that it has gone up from $2.99 a pill to $15.00 a pill. OTC will have to do.

  2. Dr. Pullen says:

    Elizabeth: I have reread carefully, and it looks correct to me?? DrP.

  3. Elizabeth says:

    Dr P – you have misspelled AstraZeneca. There is no hypen between Astra and Zeneca.

  4. Rebecca Buchanan says:

    My script cost me me over $112.00 and I am uninsured and unemployed, thanks astra-zenca!

  5. Dr. Pullen says:

    A.H.: Drug names are often generated randomly from available letter combinations. Really. No logic at all. DrP.

  6. A. H. Ferdous says:

    excellent drug but i want to know the meaning of Vimovo

    or brand logic of vimovo

  7. Dr. Pullen says:

    Pat: This is the exact strategy of big pharma with their drug coupons. I posted on this earlier at Discount Drug Coupons Check it out. DrP.

  8. pat says:

    My Dr. prescribed vimovo. she gave me a sample that came with a discount card. For one year,I paid only $20 a month. After that I had to pay $120, a month, even with my insurance. I quit using it, even though it worked . I am starting on Meloxicam now. Hope it works as well as Vimovo

  9. Kathy Crownover says:

    I was prescribed this pill with no insurance. You are wrong, about people with no insurance getting it for only $10, anyone without insurance only gets the first $75 off. My script today cost me over $36. Odd that people with insurance and don’t need help get it for $10 and those of us without insurance has to pay more. Will not be refilling if it doesn’t help, I was taking generic Naproxen before this without much luck.

  10. Dr. Pullen says:

    Sri Salla: I’d expect to see some help by 3 weeks. DrP.

  11. Sri Salla says:

    I am taking Vimovo medicine nearly three weeks regularly, however still I am feeling back pain, normally how long it takes to reduce the pain?

  12. kathy says:

    Have been on arthotec for about 6 months. Did nothing for pain. Have had many surgerie son neck and back and knee. Domino effect, I guess, now I have another herniated disc above neck fusion and pinched nerves. Just got prescribed VIMOVO, will give it a shot after I have epidural next Tuesday.

  13. Dr. Pullen says:

    Mike: Consider generic omeprazole and save even more. DrP.

  14. Mike says:

    Yep, cost me $58.50 for 30 pills. Insurance will not pay. When I run out I will start taking Nexium 10 minutes before I take neproxen and save some money.

  15. steve says:

    Pharmacists talk amongst themselves. I only have 2 comments: I can say that this medication is smart since it protects the patient before naproxen release.
    2. Problem arises- We have had no insurance pay for this without rigorous prior authorization. This upsets both doctor and patient. Doctor many times gets mad and will not do paperwork required and give up. Patient keeps returning and gets mad that rx is not approved.
    This is unpleasant.

  16. Dr. Pullen says:

    Janet: It is likely your insurance may not pay for Vimovo at all, and you may need to either combine a generic PPI with naproxen or pay the full cost. DrP.

  17. philsie says:

    If you think it’s irresponsible to, as a drug company, spend millions of dollars and several years to test and develop and get FDA approval for a product that is sold as generic components, then think how irresponsible it is to flippantly tell people that popping the two generics at the same time is, given you have done no clinical trials to prove it to be true.

    Think for a moment! The reason Vimovo is wrapped in Nexium is to allow the Nexium to act on the stomach before the Naproxen can start eating aggravating it. Maybe taking the two generics could work the same, but maybe you have to take the Nexium first, wait 5-10 minutes and then take the Naproxen. Tell me how well that will work with the thousands of elderly that might be taking this?

    It’s so easy to write an article, wave your hand, and completely dismiss something. You wanna do something hard, try getting a drug through the FDA!

  18. Janet Pool says:

    My insurance will not pay for Vimovo but it works better then any other. I took it for 6 days and it worked wonders. How can I get them to pay for it and I am more then willing to pay my co pay.

  19. Leigh Saint-Louis, MD says:

    Hi, Dr Pullen,
    I had a patient request this dumb medication, which I’d never heard of, and found your post by Googling it. The comments are startling, and make me wonder just how aggressive A-Z’s marketing is. I have never in my life heard a patient chastise a doctor for being cost-conscious and medication-savvy, so I have to wonder if the comment is from a patient or a marketer.
    I practically never advise a patient to take ANY proton pump inhibitor, anyway, unless they’re bleeding or something, because it is so extremely difficult for many patients to ever STOP taking them, due to rebound hyper-secretion of stomach acid. It seems very sneaky to me that A-Z would combine the PPI with the NSAID and charge top dollar for the “new formulation,” to provide a drug that’s otherwise cheap and generic but nevertheless not an optimal way to manage pain.
    This med reminds me very much of “Arthrotec,” which is diclofenac (painkiller) + misoprostol (stomach protectant), both $4/month at Wal-Mart, Target, and other big-box store pharmacies, yet hideously expensive and obviously a moneymaker for its parent corporation as a brand-name drug. (This kind of combo, of cheap generics and NOT involving anything ending in -prazole, is what I’d prefer for pain management.)
    In my practice, my patients aren’t only concerned with their out-of-pocket expenses, although I work hard to find them the most affordable options for everything (meds, imaging, labs, etc.). They are well aware that when sick folk are charged through the nose, SOMEBODY ends up paying for it, and they know it’s not the millionaires who own drug, insurance, and large group practice corporations.
    Appreciate this info! Thanks,
    Leigh Saint-Louis
    Family Doctor
    Eugene, Oregon

  20. Travis says:

    Looking from a pain point of view, I have been on Vimovo for about three months and have had great successes with this medication. As a long term Mobic user, I suffer from stomach pain. I tried the combining the medience myself and it never worked. To me this medicence is great.

    As to the price I have used the discount card since I started the medicence and it has saved me a great deal. There maybe cheaper combinations but I am not sure they are as effective for me.

    As to the lady how’s husband is using after surgery, they only thing I can say is it took about a week for the medication to work at full strength.

    Good Luck
    Good luck to all

  21. Dr. Pullen says:

    Mikie: I think you are naive about the drug companies coupon strategy. It is all about tempting physicians to use expensive drugs for their profits.

  22. mikie says:

    This is mostly rhetoric.

    Clearly the good Dr dosesn’t understand the machinations around pricing strategies. What it costs the patient is really all he should care about. The rebate and discount system generally means that the pharma company give it all back inside of 30 days. Like the old joke, I lose a dollar a pill but make it up on the volume.

    If you go to costco and sams you’ll see that buying an alleve and a prilosec is a heck of a lot more expensive than a couple of months of a $10 co-pay for vimovo.

    And I am not an AZ person, nor an apologist for them or pharma. Its just that these blogs are more about surface bullshit than fact. A qualification doesn’t mean you’re any good at what you do.

    In pharmqa its getting like car sales. They make money on financing and the 30 – 60 days holding money before they give it all back.

    If you want to save drug money, look at the drs and their poly pharmacy ways. Nothing really changes.

  23. Megn says:

    My husband just had liposuction due to gynocomastia and three days after the surgery the doctor told him to take vimovo instead of the percocet. I know this is an NSAID and I can understand the reasons behind the doctors decision, but really. If the IBU he was taking with the percocet wasn’t touching the pain, how can just Alieve with Nexium do the trick. He still needs the percocet, it’s only been 4 days since the procedure and the Vimovo isn’t working for his acute pain, for obvious reasons. Other than day to day pain and arthritis, you will need something stronger. I suggest taking the Vimovo and the analgesic together if the pain lasts for awhile so you don’t have stomach issues with the additional NSAID you will be taking to cut through the pain.

  24. Steve says:

    I take this and it relieves my pain I think itnis great

  25. Francis Chabot says:

    I agree with Dr. Pullen’s assessment except for the cost of generic omeprazole would be twice what he stated (to get to 80 mgs of omeprazle which would be biologically equivalent to 40 mgs of nexium. anyways first time I read your blog and agree with your philosophy. I wonder why the FDA would approve such a product?

  26. joy lee aldridge says:

    I began vimovo yesterday. I have had bad knee pain, neck and arm pain, and my middle finger on my left hand does not bend without jerking. Each morning it is painful to move until I am up and around about an hour. I work at a job which requires me to bend, lift, and be up and down in the floor all day. Will this drug help, I had been taking 8 to 10
    over the counter pain pills a day for months. Please e-mail some infor as my Dr. is to call me in two days with some test results: I would like to discuss this with her more.88

  27. Dr. Pullen says:

    Well stated Patrick. Dr. P.

  28. Patrick Mayo says:

    I wish that there was something we could do about this type of thing. In my mind it’s just another way for the drug companies to make money with no real benefit to the consumer. I believe in free enterprise but there has to be a point where you move into the area of pure greed. I think Astra-Zeneca found that point. I guess the question is how many Doctors really see past the scam and don’t fall for it. Ultimately that is the final answer. If the drug is not prescribed then it will eventually just fade away.

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