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Pharmacy Trends for 2013 and Beyond

May 29, 2013 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

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As pharmacy trends shift and costs for plan sponsors increase, we continue to maintain a panoramic view of the industry to control medication spend for our clients. By keeping plan sponsors informed of these shifts and our strategies for handling them, plan sponsors are empowered to make informed choices about their pharmacy benefit plans. In the spirit of our transparent business approach, following are some key trends we foresee occurring in this marketplace.

Generics Plateau

In 2012, new generics entering the market reached record highs, with more than 80% market share as two major brand products (Lipitor and Plavix) lost their patents. The product with the fastest growth in 2012 was atorvastatin  – the generic version of Lipitor. The medications were considered blockbuster agents, with more than $1 billion in annual sales before turning generic.

While sales of generics grew, sales of brands decreased. Because of the influx of generic products, 2012 was a marquee year. As such, we expect fewer generics exclusivity periods in coming years, and generics are expected to reach a ceiling where they can no longer surpass their current market saturation.

Growth & Trend by Therapy Class

Therapy classes with the most growth in 2012, based on total scripts dispensed, included:

• Anti-depressants • Seizure disorders • Proton Pump Inhibitors

The top five therapy classes, which accounted for one-third of plan sponsor drug spend, included:

• Oncologics  (used to treat cancer) • Respiratory agents (used to treat asthma and Chronic   Obstructive Pulmonary Disease (COPD)) • Antidiabetics (used to lower elevated blood sugars) • Lipid regulators (used to lower high cholesterol or related   disorders) • Antipsychotics (used to treat schizophrenia and related   disorders)

Trends in Specialty

Less than one percent of the U.S. population uses specialty medications, but these products account for 25% of all pharmacy spend. As you are aware, the staggering costs in this pharmacy channel are not new. The good news is that we hope to see increased competition soon, with 38 specialty products expected to have patent expirations through 2017, and new legislation that will promote competition in this therapeutic space.

At the same time, the FDA has approved many more drugs in recent years that treat oncology and orphan diseases. Orphan drugs are used in treating very rare diseases, known as orphan diseases. Because of the niche market on these products, the cost to produce and sell them is very high. For instance, five of the most recently approved orphan drugs will cost at least $150,000 per patient per year. Costs for these products will only continue to rise, since drug makers and biotechnology companies for these products currently have no competition.

Michigan Based Retail Pharmacy, Meijer, Offers Generic Cholesterol Reducing Prescription Drug, Lipitor, For Free

September 04, 2012 By: Nadia Category: Cholesterol, Free Prescriptions, HealthCare, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Drugstore News, 9.4.12 – By Alaric Dearment

In what could symbolize the so-called “patent cliff” that an executive from healthcare market research firm IMS Health spoke of at a recent trade show, a regional mass merchandise chain is taking what used to be the world’s top-selling drug and giving it away for free.

Meijer announced Tuesday that it would offer generic versions of Pfizer’s cholesterol drug Lipitor (atorvastatin calcium) for free at all of its 199 pharmacies, saying it would be the first retailer in the Midwest to offer such a program. The program is the fourth free-drug program offered by the retailer over the last six years.

“We’re pleased to announce that our customers will now be able to fill their generic cholesterol-lowering atorvastatin calcium prescriptions for free in all of our pharmacies,” co-chairman Hank Meijer said. “In keeping with our commitment to provide low-cost solutions for the families we serve, the free cholesterol-lowering medication program is another way to help the customers who rely on our pharmacies.”

Before it lost patent protection, in November 2011, Lipitor had sales exceeding $7 billion per year in the United States. Ranbaxy Labs was the first to launch a generic version when the drug’s patents expired, and Ranbaxy’s own market-exclusivity period expired in May of this year. At the National Association of Chain Drug Stores’ Pharmacy and Technology Conference last month, IMS VP industry relations Doug Long said during a presentation that “We’re in the teeth of the patent cliff,” which refers to a period taking place over the next few years when a wave of expirations of several top-selling drugs’ patents will occur, eventually leaving many therapeutic indications such as cholesterol heavily commoditized and dominated by multiple generics.

“This initiative will have a huge impact because the cost of pharmaceuticals is frequently a barrier to getting appropriate treatment,” West Michigan Heart cardiologist and Spectrum Health Meijer Heart Center Cardiac Catheterization Labs director David Wohns said. “The biggest way to reduce the risk of heart disease comes from treating cholesterol. To have that drug available for free has the ability to impact countless lives.”

How Much Money Will Generic Lipitor Save?

January 03, 2012 By: Nadia Category: Cholesterol, HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Wall Street Journal – Katherine Hobson, 12.12.11

We’ve written about some of the most common consumer questions about the newly launched generic version of Pfizer’s cholesterol-lowering Lipitor.

One remaining question is how much money will be saved from the generic iterations of the name-brand blockbuster — the U.S. sales of which were $7.8 billion in the year ended Sept. 30, according to IMS Health.

A group of researchers takes a stab at that issue in a perspective piece published online by the New England Journal of Medicine. Their conclusion: “the overall cost savings from the availability of generic atorvastatin are projected to reach $4.5 billion annually by 2014, equivalent to 23% of total expenditures on statins in that year.” (The aging population could mean another $30 million of cost savings annually by 2014, they note.)

To make their calculations, they looked at what happened after Merck’s Zocor lost patent protection in 2006, and also considered how the aging of the population would drive future demand for statin drugs. They predict that generic atorvastatin will “dominate the statin market as a result of patients’ switching to it from simvastatin [generic Zocor] and from [AstraZeneca’s] Crestor, and it will have an estimated market share of 44% by 3 years after market entry.”

The researchers, from institutions including the Western University of Health Sciences and Yale University, project that the price of generic atorvastatin will be 82% of the pre-generic Lipitor at the time of market entry and 49% of the brand-name after the first six months.

However, these projections come with an asterisk: they “estimate what would happen with the rapid availability and timely uptake of generic atorvastatin.” The researchers say “aggressive business tactics” used by Pfizer to keep people using name-brand Lipitor, including deals with pharmacy-benefit managers and discounts to patients, may prevent switches to the generic.

“In order to capitalize on this opportunity for cost savings from the expiration of Lipitor’s patent, there must be a rapid, concerted effort by many players in the health-care system to facilitate awareness of and access to the generic,” they write.

Lipitor Goes Generic, As Good as Crestor, But Pfizer Markets to Extend Brand Revenues

December 12, 2011 By: Nadia Category: Cholesterol, HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: USA Today, 11/15/2011

On November 30, 2011, the cholesterol medication Lipitor (atorvastatin) converted to generic status. For the first six months, two companies, Watson Pharmaceuticals, Inc. and Ranbaxy Laboratories, Ltd., will produce the generic. After May 2012, several generic manufacturers are expected to enter the market.

Pfizer Inc., the maker of Lipitor is marketing hard for people to keep buying its brand-name version for the next 6 months. Pfizer is offering

  • patients a discount card to get Lipitor for $4 a month, and
  • rebates to insurance companies that cover Lipitor for the next 6 months.

This action by Pfizer will result in the costs of Lipitor being below generic prices and Pfizer will get 70% of the proceeds from one of the two versions sold now.

USA Today reported, that large doses of Lipitor and Crestor did about equally well according to a study of 1,385 patients presented at the annual meeting of the American Heart Association in Orlando. Crestor, made by AstraZeneca, “will be the last major statin not on patent,” said Cam Patterson, chief of cardiology at the University of North Carolina-Chapel Hill, who was not involved in the study. “The market for Crestor will go close to zero.”

Study findings

At the end of the two-year study,

  • Two-thirds of patients had less plaque in their arteries.
  • Both statins shrunk the size of plaque in the coronary artery by about 1%.
  • Patients on Crestor had a low-density lipoprotein (LDL) level of 63 milligrams per deciliter, while those who took Lipitor had a level of 70.
  • Patients on Crestor had a high-density lipoprotein (HDL) level of 50 milligrams per deciliter, compared to 49 for those who took Lipitor.

Nehal Mehta, a cardiologist with the University of Pennsylvania’s School of Medicine, says there’s no way to know if such a small change actually matters, in terms of preventing heart attacks and saving lives. And relatively few patients would even benefit that much. Only about 20% of patients are taking such high doses — 40 milligrams daily of Crestor or 80 milligrams daily of Lipitor, says Mehta, who wasn’t involved in the study.

Such minor differences in cholesterol levels are unlikely to affect heart disease risk, Patterson says. “The bottom line is that there isn’t a difference” between drugs,” he says. “You should make your decision on other factors, like which one is least expensive.”

About Lipitor and Crestor

Cholesterol medications are the leading class of prescription drugs in the USA, with 255 million prescriptions a year. Lipitor — the country’s best-selling drug, with sales of $7.2 billion last year — will be available as a generic Dec. 1, at a fraction of its current cost. Patterson says there will be no reason for insurance plans to pay for Crestor — the eighth-leading drug in the USA, with $3.8 billion in annual sales. In fact, by next month, nearly all statins will be available generically. Generics now account for 78% of all retail prescriptions sold, according to IMS Health.

Atorvastatin – generic for Lipitor

September 14, 2011 By: PharmaSueAnn Category: Medtipster

Atorvastatin – generic for Lipitor is scheduled to be released on November 30, 2011. Although it will be quite a while before we see atorvastatin on a $4 list, it’s availability will allow many of us to see a reduction in prescription drug co-payments.

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