Briefs: rebates; $67 billion; PBMs; and pill dumping

CVS Health Chief Policy and External Affairs Officer Tom Moriarty spoke to attendees at the AHIP National Policy Conference in Washington, DC, March 8, about ways the company is addressing the high cost of prescription drugs for payors and consumers.  He highlighted a variety of approaches, including a new program that provides drug cost transparency for prescribers, pharmacists and patients.  He also discussed the company’s existing Point of Sale rebate offering which passes negotiated drug rebates directly to consumers when they purchase their medications.

Cigna plans to purchase Express Scripts for $67 billion.

The National Association of Chain Drug Stores is supporting federal legislation requiring e-presribing for Medicare Part D beneficiaries.

United Health announced in March that enrollees in fully insured group health benefit plans will have manufacturers rebates and discounts applied to their medication cost at the point of sale.  This move was praised by HHS Secretary Azar who said the effort will help ’empower” patients with the “information and control to put them in the driver’s seat,” which is a key part of HHS’ strategy to “bring down the price of drugs and make healthcare more affordable.”

Secretary of HHS Alex Azar in a speech to the Federation of American Hospitals discussed the need for greater transparency in the U. S. health care system, including prescription medications, stating “Your pharmacist typically cannot tell you the real price you’re going to pay for a drug, and therefore your out-of-pocket cost, until they actually create a claim.  So this is a crucial piece of our efforts to bring down prescription drug costs, too.”  He also noted, “This thicket of negotiated discounts makes it impossible to recognize and reward value, and too often generates profits for middlemen rather than savings for patients.”

Meanwhile, Scott Gottlief, Commissioner of the Food and Drug Administration, specifically called out PBMs noting that their negotiated savings aren’t being passed along to patients at a speech to the America’s Health Insurance Plans.

Purdue says it will stop promoting opioid drugs to doctors, bowing to a key demand of lawsuits that blame the company for helping trigger the current drug abuse epidemic.   Purdue’s statement said it eliminated more than half its sales staff in February and will no longer send sales representatives to doctors’ offices to discuss opioid drugs.  Its remaining sales staff of abut 200 will focus on other medications.

West Virginia lawmakers rejected a proposal during the 2018 session that would have required drug companies to report the number of prescription opioid manufactured and shipped to the state during the past decade.  Senator Stephen Baldwin, D-Greenbrier, who offered the amendment, said the state has failed to hold drug companies accountable for the opioid epidemic.  He called the manufacturers and distributors “one of the primary perpetrators” of the public health crisis that claims 880 lives a year and costs the state an estimated $8 billion.  (Charleston Gazette-Mail, February 16, 2018)

In just two years, McKesson Corp. drug wholesaler shipped nearly 5 million prescription pain killers to a single pharmacy to a Southern West Virginia town with 400 residents, according to a letter released February 15 by a congressional committee investigating the opioid epidemic.  The wholesaler supplied more than 184,000 hydrocodone pills a month to a drive-thru pharmacy in Kermit in 2006 and 2007, the House Energy & Commerce disclosed in the letter.  The congressional panel, which has been investigating pill dumping in West Virginia for nearly a year, sent letters to the nation’s three largest drug distributors — McKesson, Amerisource Bergen and Cardinal Health — asking the companies to turn over documents and answer questions about massive shipments of pain pills to small-town pharmacies in West Virginia.   (Charleston Gazette-Mail, February 16, 2018)