you are completely wrong. first, brand and generic have the same active ingredient in the same formulation, it's only the fillers that are different. when a brand goes to generic, the brand is still available. for example coumadin is still available, warfarin is the generic. plaquenil is still available hydroxychloroquine, is the generic. lasix is still available, furosemide is the generic, etc etc etc. second, when a discount card is used, yes the insuranse company gets billed!!!! the pharmacy bills the insurance company first, they get a copay, then they bill the coupon card, which, in this case, acts as a secondary insurance and that reduces the price to a final copay. ie. you want lipitor, your copay for brand lipitor is $25. the tech runs the information and gets a paid claim for $25, then the tech eneters the information from the card and then gets a paid claim for $4. i know it works this way because i work in the pharmacy industry as a pharmacy technition and i'm studying right now to be a registered pharmacist!!!!! ps the reason many pharmacy benefit managers are implementing step therapy is to prevent the use of coupon cards and save money.

two points that are wrong here. branded products and generic products do not have the same ingredients. when a product goes generic the branded product is no longer sold. while there my be new drugs introduced in that class of drugs there are vast differences in what is in a generic and the branded products. secondly, while rebate are out there to reduce cost the real scam is generics. branded products offer a rebates and the difference is paid by the drug company and not the managed care company. there may be cases when the difference is split between the two, however most popular generics cost the same as a branded product and offer no relief. while generics may cost less at the counter they are billing the managed care the difference and not paying any rebates to managed care. it's the biggest fleecing of america i've seen.