In an effort to hold onto sales of cholesterol fighter Lipitor after the drug loses patent protection at the end of this month, Pfizer is planning to sell the pills at generic prices directly to patients, breaking a longstanding triad between the patient, prescriber, and pharmacist, which provides a system of checks and balances for delivering medication therapy, The Wall Street Journal recently reported.Â
Lipitor, the top-selling drug of all time, has made Pfizer more than $81 billion in sales since launching in 1997, according to IMS Health. At its peak, more than 11 million Americans took it, says Wolters Kluwer Pharma Solutions, another health-care data firm.Â Â
Because most patients see multiple prescribers, when a patient uses a single pharmacy the risk of drug errors is reduced substantially. By interjecting a Pfizer Pharmacy for a single drug, at least one leg of the triad is undermined creating the risk of duplicative therapy since neither the planâ€™s nor the pharmacyâ€™s records would be complete for the patient.
In letters to pharmacists last week, PBMs instructed pharmacies to continue dispensing brand Lipitor for the next 6 months. This reversal of business as usual reflects new tactics by Pfizer to keep sales afloat as generic competition threatens its blockbuster drug.Â Pfizer has agreed to large discounts for benefit managers that block the use of generic versions of Lipitor, according to a letter from Catalyst Rx, a benefit manager for 18 million people in the United States. The letters have not previously been made public.
Earlier this year, Pfizer, Inc attempted to circumvent Medicare Part D formulary regulations by offering generous rebates to PBMs to block the addition of generic Lipitor, atorvastatin, and place the brand name on a preferred tier. Part D Plans are prohibited from making formulary decisions based on financial incentives to the Plan or its delegated entity, the PBM.
Dave Marley, RPh, founding member of the group and author of a Pharmacy Times blog about bringing accountability to the PBM industry, told NYT that employers and taxpayers will bear the brunt of excess costs under the new arrangementâ€”even as PBMs pocket Pfizerâ€™s rebate dollars.
To offset the expense of dispensing Lipitor instead of its generic equivalent, which would cost payers roughly $35 less, Pfizer is offering benefit managers a point-of-sale discount that undercuts the generic price. As a result, most patients taking Lipitor will see their co-pays drop to about $10 per prescription, the New York Times reported.Â The block on generic Lipitor is scheduled to lift on May 31, 2012, when several other generic drug makers are expected to launch their versions of the drug.
The GHG Blog is just the tip of the iceberg. Check out the Point for complete access to all content from GHG experts.
- After Hours
- Agent Oversight
- Brain Food
- Health Insurance Exchanges
- Part D
- Performance Optimization
- Policy & Health Reform
- Prospective Evaluations
- Provider Relations
- Risk Adjustment
- Sales & Marketing
- Star Ratings
- kdambrosio on An “October Surprise” in Medicare Advantage Star Ratings
- Garth D. Weme, CIC on An “October Surprise” in Medicare Advantage Star Ratings
- Clark on Making Order from Chaos
- RP on How to Efficiently Conduct an Audit
- Denise Gill-Vigilante on How to Efficiently Conduct an Audit