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Generic for Lyrica Could Lower Claim Costs

Friday, May 7, 2021 | 0

A generic pregabalin extended-release tablet that hit the market in April will likely lower costs on claims that include Lyrica CR as part of the medication regimen, according to Optum Workers’ Comp and Auto No-Fault.

Although Lyrica CR is not commonly seen in workers’ compensation Medicare Set-Asides, Optum said it expects that the newly released generic will be about 40% cheaper.

The generic extended-release pregabalin formulation is approved only to manage pain caused by damaged nerves related to diabetes and shingles. Unlike the immediate-release formulation, it is not approved for nerve pain associated with spinal cord injuries, seizures or fibromyalgia, Optum said.

“It is our recommendation that carriers, (third-party administrators) and claim handlers flag cases where brand-name Lyrica CR has been prescribed to determine if generic pregabalin ER is prescribed in the near future,” Optum said. “It is expected that over the next several months, we will see prescriptions for brand-name Lyrica CR transitioned to the generic formulation. If not, it is recommended that a request be made to the treating physician to initiate a trial of the generic medication.”

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