Infamous Combo-Drug Now Has a Generic Available

Our old friend Duexis® is back in the news. Not really, not yet, but we’re putting it out there now.

You may remember this drug, an 800 mg/26.6 mg combo of ibuprofen and famotidine commonly prescribed for rheumatoid arthritis. At last check, wholesale acquisition cost (WAC) or “list price” was $2,482 for a 30-day supply (90 tablets).

This week we noticed that a generic for Duexis hit the market. Its $404 WAC represents a healthy 84% drop over the brand product. That doesn’t change the fact that the active ingredients in equivalent prescription strengths can be taken separately for around 20 bucks.Duexis¨ = Ibuprofen 800mg + Famotidine 20mg

A patient could even get the same therapy over the counter (there would just be more tablets to take):Patients can get the same therapy as Duexis¨ by using over-the-counter options like Advil and Pepcid (there would just be more tablets to take)Takeaways

  • Despite the high cost, we still see thousands of member claims for the brand product Duexis every year.
  • We expect the generic product to start showing up in claims now that the FDA has approved it, roughly 6 months after manufacturer Alkem Labs prevailed in court vs. Duexis maker Horizon Medicines.
  • Curiously, as of publication time, the product isn’t yet listed on Alkem’s website or that of its subsidiary, Ascend Laboratories. This could be by design, perhaps to fly under the radar and help the drug find its way on to formularies as a generic—albeit an expensive one.
  • The Duexis combo has always been marketed as a way to relieve pain and inflammation with a high dose of ibuprofen, and to fend off gastrointestinal damage with famotidine, all in one dose. Generic Duexis will no doubt ride that built-in “convenience” factor of taking one pill instead of two.
  • However, this product is yet another example of generics not always being the best choice for controlling costs. Sure, the 84% reduction in list price will look good to many decision-makers in pharmacy. Until it’s compared to the price of its two active ingredients taken separately…

A chart shows options for Duexis¨ treatment, including the brand-name option, new generic and our suggestion that uses over-the-counter options.

Rest assured, we’ll keep an eye on our clients’ claims and monitor prescribing trends for generic Duexis. As always, we’ll point any affected members to the lowest-cost option.

Yes, even with this generic, there’s still a steep price to pay for one-pill convenience. The costs and the waste can be avoided by taking two pills for one small bill—the one with Andrew Jackson on the face.


Reetu Karusala, Rx Savings Solutions Engineering ManagerSpecial thanks to Reetu Karusala, Rx Savings Solutions Engineering Manager, for her data sleuthing work that contributed to this report.