Richard Rubino, senior vice president and controller of Medco Health Solutions Inc., told health care analysts and investors two weeks ago at the Banc of America Securities conference in Las Vegas that his company has taken steps to reduce drug costs by encouraging generic medications.

Medco, which has a dispensing facility in Henderson, is a pharmacy benefit manager that fills maintenance prescriptions for health plans and employer-sponsored plans.

Jennifer Leone, a spokeswoman for Medco, said the company established its "generics first" program in 2000 to educate physicians and patients about "the benefits of generic drugs as a lower-cost alternative when clinically appropriate."

The program operates in 14 regions -- none of which include Nevada -- and involves 10 Medco pharmacists meeting with physicians and mailing information about generic drugs, which are drugs that are no longer patented or marketed.

"That's the advantage brand name drugs have over generics is that they are marketed," Leone said. "Marketing does have an impact (and is) one of the reasons we started this program."

Medco has reached about 10,000 physicians, Leone said.

Doctors in those regions, the closest to Nevada being Salt Lake City, can receive nine types of generic drug samples for patients with ulcers, gastro-intestinal disorders, depression, high blood pressure, allergies and pain, she said.

"Since 2000, we have given out nearly 3 million samples, representing 20 million days of therapy," Leone said.

The idea is for doctors to think about generics when they give samples to their patients, which shifts patients' prescription habits, she said.

"The patient is more inclined to use that drug because it's top of mind," she said of the generic samples. "Generics are FDA approved. They contain the same active ingredients yet they're a fraction of what a brand name drug costs. It offers significant savings to patients and to the people that pay their plans."

It is uncertain whether Medco's program will expand to Nevada but it could mean big savings for employers and health plans.

Medco's generic programs saved the company's clients -- employers and health plans -- $45 million for every $100 million they spent on brand name drugs, Leone said.

PacifiCare Health Systems Inc., which operates health plans and a pharmacy benefit manager company, launched a program to promote generic drugs in 2000. The company, which sells health plans in Nevada, provides generic drug samples to doctors in eight states including some in Nevada, for the treatment of hypertension, cardiovascular and gastrointestinal disorders, pain management, diabetes and antibiotics.

Las Vegas Valley doctors say they like the idea of having generic samples and would use them if they were available.

"I personally would be open to it and I would suspect most doctors would be," said Dr. Michael Colletti, a Las Vegas rheumatologist and president of the Clark County Medical Society. "I think it's a great idea. Doctors are very aware patients are having trouble affording medication."

He said that in Las Vegas, doctors only receive samples of brand name drugs, which are often expensive for patients and their health plans.

"It would be advantageous to convince the public that generics are just as good and are the same thing," Colletti said.

"Drug reps and pharmaceutical reps are getting criticized for marketing to the doctors too much," he said. "I like to have samples to give out to my patients, especially if it's samples of the drug they can't afford to buy."

In other health care news

The Nevada Orthopaedic Society was recently named as the state society of the year by the American Academy of Orthopaedic Surgeons for its involvement in Nevada malpractice tort reform. The state society received a $30,000 grant to raise awareness of the Keep Our Doctors In Nevada initiative that appeared as a public vote in November.

Michelle Swafford covers health care and small business for In Business Las Vegas and its sister publication, the Las Vegas Sun. She can be reached by e-mail at swafford@lasvegassun.com or at (702) 259-2326.