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.

42 Responses to Vimovo – Give Me a Break

  1. i received 3 boxes of these today as samples for free. I will be taking them back. I feel the government could spend what they are getting charged for this on someone who really needs medications.I just asked for some b-12 injections. The side effects scared me.I’ll deal with my pain another way. I can’t take a 2,000 Rx, that is horrid.This is the reason Medicare doesn’t work.

  2. I have been taking Vimovo for 2 years at $10 copay. Recently it changed, and I have to pay $75 but AstraZeneca gives me a $65 rebate. I do not know why Vimovo works so well, but I recently switched to prescribed naproxen 500mg and OTC esomeprazole, and I went from pain-free to agony within three days. I can barely even walk. Now that makes NO sense at all, so I’m going to ask my doc and pharmacist why on earth it would make such a big difference.

  3. If you pay $100 for a Nsaid that is available OTC for under $15, you’re a moron. And stop bitching about Insurance companies. If you don’t have insurance, you can get a job, and get health insurance. But than you’d have to stop crying about your ailments and get you fats off the couch. I know the choice you’ll take, you lazy whiney bastards. I got this drug for $10 and I have health insurance that didn’t cover it. I received a coupon.

    If your prescribed drugs cost you over $2000 a month out of pocket, you might want to look into gun and a bullet.

  4. I cannot disagree with your assessment of greed over profit. This problem long predates Obamacare, and is directly related to insurance companies, not the government rationing. DrP.

  5. SW: Generally we try to have patients take only one NSAID at a time, i.e. either but not both ibuprofen or meloxicam. With any NSAID we usually check kidney function from time to time, every 3-12 months depending on what med, what dose, what your baseline kidney function may be, and/or other medication use. DrP.

  6. If I am already on omeprazole 40 mg couldn’t I just add 500 mg of naproxen and get the same effect as vimovo 500mg? I am taking meloxicam but the dr, says I have to have blood work every 3 months for kidney function if I stay on it.

  7. I have severe arthritis and a history of G.I. “bleeds”. Vimovo was prescribed for me 5 years ago and it was a godsend. Problem is, I just received word that my insurance will no longer cover it due to escalating costs. Alternatives were recommended which would mean taking two pills instead of one with no guarantee that it will address my dual problem. This “smacks” of rationed care promoted by the government and drug companies. Vimovo is not new to the market and doesn’t justify the huge price increase. A product is useless if the average person can’t afford it. I agree with Patrick Mayo regarding free enterprise but this is more of an example of greed than profit.

  8. Wow… That’s just bisarre. I take Vimovo and meloxicam and I pay about 19USD. For a month. Guess I’ll have to stop complaining about our healthcare system being expensive. But I don’t get how they manage to keep prices so high? Over here they are pushing the cost down and trying to keep customers, and a bankrupt customer won’t be a customer for long.

    I feel for all of you, being stuck in a inhumane society. Weird how even Russia manages to give healthcare to it’s people, when the us don’t.

  9. My wife’s doctor recently prescribed Vimovo for treatment of her RA. We took the prescription to the pharmacy and they said the cost for 60 tablets would be a little over $1000.00. A web site called GoodRX Prices gives all the prices, about $1065 at all major pharmacies. Our insurance BC/BS declined to pay the prescription at all. I do not blame them. I found a foreign pharmacy where I can get 60 of these pills for $75.00 with a prescription. All I had to do was send them a prescription by email attachment and a total of about $85 to cover the price of the RX and shipping and handling costs.

    You can buy all three generic ingredients of Vimovo at your local Dollar General store for less than $15.00. All the pill manufacturer has done is wrap them up in a time-release capsule so you don’t have to get up in the middle of the night to re-take the three ingredients (esomeprazole, naproxen and magnesium). Naproxen is always good for about 8 hours, and esomeprazole is available in time-release pills at any discount store, such as Dollar General. Esomeprazole is just a double dose of omeprazole.

    Nearly 20 years ago I was diagnosed with RA, and no prescription medication helped. One of them cause blood in my stool. I quit taking all prescription medication and took the advice from an alternative medicine book I bought at a garage sale several decades ago. All I had to do was take yucca twice a day. About a month later at my next appointment, I went back to my rheumatologist and tested negative RA. When I told him I was taking only yucca he did not believe me. Anytime I start getting a little joint pain, I resume taking yucca (available at any health foods store), and the pain goes away within a couple of hours. I have also taken magnesium for about 20 years. For me, it prevents kidney stones and according to some sources, also helps combat arthritis, which is probably one of the reasons Vimovo works.

  10. I have been taking Vimovo for over two years. Now that I am retired, I have lost my great insurance coverage of the past. My prescription changed from under $100 to $3,000. I am immediately in a donut hole due to only one prescription. My pharmacy failed to call me and let me know the cost. I am totally discouraged with drug companies, as well as, my pharmacy.

  11. My Dr. said I have a severe arthritic back and I’m “shit out of luck” to get relief; however, he ordered me these pills for FREE! I received a huge bottle of free pills and was told they would never cost me. He didn’t bother to tell me to quit taking my 325 bayer aspirin, blood pressure/diuretic combo pill, and he did tell me to stop my Mobic. I had a stroke in January of this year and I found out I’ve had many strokes that I didn’t know of. Would I be stupid to take this pill? I must be part of a study if the meds are free. Thanks!

  12. 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.

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

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

  15. 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

  16. 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.

  17. 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?

  18. 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.

  19. 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.

  20. 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.

  21. 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!

  22. 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.

  23. 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

  24. 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

  25. 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.

  26. 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.

  27. 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.

  28. 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?

  29. 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

  30. 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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