Horizon Pharma statement Suggesting that there are generic alternatives that are equivalent to DUEXIS and VIMOVO is inaccurate. There are no approved generic, over-the-counter or clinically equivalent medicines to DUEXIS and VIMOVO. The FDA prescribing information for both medicines specifically states, “do not substitute DUEXIS with the singleingredient products of ibuprofen and famotidine” and “do not substitute VIMOVO with the single-ingredient products of naproxen and esomeprazole magnesium.” In addition, the medication guides for DUEXIS and VIMOVO state, “You should not take an ibuprofen tablet and famotidine tablet together instead of taking DUEXIS, because they will not work in the same way,” and “You should not take a naproxen tablet and an esomeprazole magnesium tablet together instead of taking VIMOVO, because they will not work the same way.” [Link to FDA-approved DUEXIS PI and Med Guide; Link to FDA-approved VIMOVO PI and Med Guide] DUEXIS is specially formulated to contain prescription strength ibuprofen and a protective core of famotidine at a higher dose since standard doses fail to provide gastric protection. The FDA approval of DUEXIS – based on two, randomized Phase 3 clinical studies that enrolled more than 1,500 patients – marked a new indication for famotidine. Previously, famotidine was not approved to decrease the risk of developing upper GI ulcers in patients taking ibuprofen or any other non-steroidal anti-inflammatory drug (NSAID) and is still not approved as a stand-alone therapy or in combination with another active ingredient for this use (except in DUEXIS). VIMOVO consists of enteric-coated naproxen and immediate-release esomeprazole magnesium. Immediate-release esomeprazole magnesium is not available over the counter or as a generic. The list price you mention below is not the amount the patient pays or that Horizon receives. Horizon has patient support programs to ensure that every commerciallyinsured patient has access to DUEXIS and VIMOVO even if the patient’s insurance refuses to provide coverage. As a result, 98 percent of all commercially-insured DUEXIS and VIMOVO patients pay $10 or less out of pocket. In addition, the list price is not an accurate representation of what health plans actually pay as they do not account for rebates to the plans/PBMs, discounts, and processing fees charged by managed care providers. Based on these factors, the average net realized price that Horizon receives for these medicines is significantly less than the list price. Finally, both medicines provide a solution to a major health problem. Every year there are more than 100,000 hospitalizations and more than 16,000 deaths related to GI toxicity, including GI bleeding that result from patients taking traditional unprotected NSAIDs. Published data indicates that less than 25 percent of physicians co-prescribe an NSAID and an agent to reduce the ulcers they cause. In the few patients that are co-prescribed, data indicates that less than 40 percent of patients are still taking the GI protective after three prescriptions. By providing the benefits of an NSAID and a medicine to reduce NSAID-induced GI ulcers in a single pill, the risk of patient non-compliance for GI protection is eliminated.