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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.”

The Three Behavioral Factors Driving Rx Spend Waste

September 27, 2011 By: Nadia Category: HealthCare, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Express Scripts 9.27.11

“We have long used financial incentive to eliminate waste. Now we’re finding that tools that build upon the insights of behavioral economics and psychology can have powerful, positive effects.”
- Alan Garber, MD, PhD, Professor of Health Economics, Stanford University

The above quote is from Dr. Alan Garber, one of the most respected healthcare economists in the country. Dr. Garber recognizes that Plan Sponsors have a critical need for a “new toolbox” to help eliminate healthcare spend waste and drive better behavior.

Plan Sponsors will certainly agree with the statement “behavior is important”, but they are also acutely concerned with dollars. They will want to know specifically – in hard dollars – how behavior is impacting their costs.

What stands between the doctor and optimal health outcomes is consumer behavior. Wasteful pharmacy-related behavior costs the healthcare system a staggering $403 billion a year:

Drug Mix: $51 billion – People using a brand drug when a generic drug would be just as effective

Channel Choice: $6 billion – People choosing to continue to get their maintenance medication at a retail pharmacy instead of using home delivery

Non Adherence: $106 billion – People not taking their medications appropriately

Clearly, consumer behavior is a factor that you cannot leave out of the equation when trying to get the most out of your pharmacy benefit. So what can we do to motivate people to change? To improve Rx spend effectiveness?

Most PBMs offer two options to increase the effectiveness of the plans performance – passive education programs and mandatory programs. Mandatory programs are effective, but because of the potential for noise, many Plan Sponsors have not wanted to use them. Passive programs solve the noise issue, but don’t achieve the effectiveness that most plans need today. So how do we move from where we are today to maximizing plan performance without putting mandatory programs in place?

We can close a great deal of this gap by applying the behavioral sciences to healthcare. This allows Plan Sponsors to achieve greater effectiveness without the member disruption.

Promising Business Model Targets Traditional PBMs

December 15, 2010 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Seeking Alpha.com – 12.14.2010

Four years ago, Walmart (WMT) launched its four dollar generic drug program. Target (TGT), Costco (COST), K-Mart (SHLD), and others implemented similar plans soon after.

Many experts expected a direct challenge to mail-order pharmacies, and head-to-head price competition. Some believed the pricing initiative doomed the traditional pharmacy benefit management (“PBM”) business model.

Not only have the major PBMs survived, they’ve thrived—and once again deflected a substantial market challenge. Shares in Medco Health Solutions (MHS) and Express Scripts (ESRX) have more than doubled. Both now trade at or near all-time highs. (The CVS Caremark (CVS) price is flat, but the company has navigated an unfulfilling merger that has so far diluted the value of the legacy Caremark operation.)

Traditional PBMs, however, should not rest too comfortably, according to a recent white paper by Milliman*, the actuarial consultancy. The paper, entitled “The Value of Alternative Pharmacy Networks and Pass-Through Pricing”, explores the emergence of transparent retail pharmacy networks that build on Walmart’s and other large retailers’ aggressive cost-cutting capabilities.

Milliman calls these new business models Alternative Pharmacy Networks, or “APNs”. The paper presents analysis that estimates cost savings of between four and 13 percent beyond a traditional PBM service for an average employer with 10,000 lives.

Even though pharmacy costs are small as a percentage of total employer health care costs (medical benefit costs can be at least four times as great), the savings are real, especially against a tough economic environment. For large corporations employing tens of thousands, scale advantages could produce even bigger percentage savings.

Because the APN creates a transparent marketplace, it bestows employers, or plan sponsors, an intangible benefit of eliminating the traditional PBM’s information advantage. The APN takes away what the PBM knows about drug pricing and how it leverages this.

Most important, the APN is an emerging model. Only a few large employers such as Caterpillar (CAT) utilize it. One catalyst—beyond sponsors seeking additional savings—could be small PBMs reinventing themselves. The three big PBMs—Medco, Caremark and Express Scripts—are powerful players. Their aggressive strategies and market consolidation leave little room for others to compete.

APNs, Miliman states, feature two characteristics: one, substantially lower drug prices and dispensing fees than traditional pharmacies; two, ‘pass-through’ attributes including rebates that flow from manufacturer to employer and a PBM that collects no spread or drug cost differentials. (Instead of rebates and spreads, the PBM makes money on a flat administrative fee.)

Whereas, in the traditional model, PBMs negotiate price with plan sponsors, the APN model allows in-network pharmacies to compete for consumers on price and service. Control, in effect, shifts to the employer (the payer), and, depending on how the employer arranges the APN, the consumer.

So why haven’t APNs gained greater momentum? There are several reasons. Perhaps the most important is the resilience of mail order, the traditional PBM’s core franchise. Mail order is a distinct class of trade, the Milliman paper notes, which means PBMs can purchase drugs from manufacturers at prices lower than wholesalers or retail pharmacies. It also allows for price arbitrage strategies not available to retailers.

The traditional model also wins on market inertia. While the APN does offer real savings, traditional PBMs can argue that they too create savings, and have been doing so for years. Sponsors focus more on trend than details anyway, and new contracting means hassle. Moreover, sponsors care much more about the medical side of the ledger, since it’s the principle contributor to price inflation.

No doubt, if the number of employers weighing the APN option accelerates, then the PBM universe could rebalance. The odds of the traditional model collapsing appear slim, however.

For small PBMs and new entrants, the APN model does finally establish a vehicle that can compete against the big three PBMs.

More than existing share, revenue that the APN does claim will likely constitute new share in a growing marketplace of aging baby boomers and new-to-market oral specialty pharmaceuticals.

The big three PBMs have consistently shaped and dominated the pharmacy distribution chain. As time passes, their biggest risk may not be the APN, but their own success in building behemoth businesses that ultimately limit maneuverability.

*Medtipster.com Note: Medtipser.com, LLC. operates as an Alternative Pharmacy Network (APN) and offers a unique APN employer product saving an average of 10% over a traditonal pharmacy benefit manager.

Steep Co-Pays May Cause Some to Abandon Prescriptions

November 17, 2010 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News

www.Medtipster.com Source: HealthDay, 11.15.2010 – By Serena Gordon

In these tough economic times, even people with health insurance are leaving prescription medications at the pharmacy because of high co-payments.

This costs the pharmacy between $5 and $10 in processing per prescription, and across the United States that adds up to about $500 million in additional health care costs annually, according to Dr. William Shrank, an assistant professor of medicine at Harvard Medical School and lead author of a new study.

“A little over 3 percent of prescriptions that are delivered to the pharmacy aren’t getting picked up,” said Shrank. “And, in more than half of those cases, the prescription wasn’t refilled anywhere else during the next six months.”

Results of the study are published in the Nov. 16 issue of the Annals of Internal Medicine.

Shrank and his colleagues reviewed data on the prescriptions bottled for insured patients of CVS Caremark, a pharmacy benefits manager and national retail pharmacy chain. CVS Caremark funded the study.

The study period ran from July 1, 2008 through Sept. 30, 2008. More than 10.3 million prescriptions were filled for 5.2 million patients. The patients’ average age was 47 years, and 60 percent were female, according to the study. The average family income in their neighborhoods was $61,762.

Of the more than 10 million prescriptions, 3.27 percent were abandoned.

Cost appeared to be the biggest driver in whether or not someone would leave a prescription, according to the study.

If a co-pay was $50 or over, people were 4.5 times more likely to abandon the prescription, Shrank said, adding that it’s “imperative to talk to your doctor and pharmacist to try to identify less expensive options, rather than abandoning an expensive medication and going without.”

Drugs with a co-pay of less than $10 were abandoned just 1.4 percent of the time, according to the study. People were also a lot less likely to leave generic medications at the pharmacy counter, according to Shrank.

The medications most frequently abandoned were cough, cold, allergy, asthma and skin medications, those used on an as-needed basis. Insulin prescriptions were abandoned 2.2 percent of the time, but Douglas Warda, director of pharmacy for ambulatory services at the University of Chicago Medical Center, said this might be a cost issue, but it could also be that some people are afraid to inject insulin.

The study also found that antipsychotic medications were abandoned 2.3 percent of the time.

Drugs least likely to be abandoned included opiate medications for pain, blood pressure medications, birth control pills or hormone replacement therapy, and blood-thinning medications, according to the study.

Young people between the ages of 18 and 34 were the most likely to forgo their prescriptions, and new users of medications were 2.74 times more likely to leave their drugs behind.

Prescription orders that were delivered to the pharmacy electronically — via the computer — were 64 percent more likely to be abandoned than prescriptions walked into the pharmacy.

“We’re definitely not saying that e-prescribing is bad; it’s great, but there appear to be some unintended consequences,” said Shrank.

There was no way to tell if people never tried to pick up their prescriptions, or if they went to retrieve them but chose to leave them behind because of the cost.

Warda said he believes that more patients might pick up their medications if the instructions from their physicians were clearer. For example, prescriptions for proton pump inhibitors were left at the pharmacy 2.6 percent of the time. These medications reduce the amount of acid in the stomach and can help prevent heartburn or more serious problems. “If the physician message is, ‘You need to take these medications for two to three months and it will reduce your pain and help your body heal,’ fewer people might abandon these medications,” he said.

Plus, if cost is an issue for you, bring it up with your doctor ahead of time, he added. “Don’t get blindsided at the pharmacy. Always ask your physician if there’s a generic option, or if there’s something cheaper that might work just as well. Sometimes people are embarrassed to say anything, but it’s better to ask and get a medication you can afford.

“If you get to the pharmacy, and you can’t afford the medication, follow up with your doctor or ask the pharmacist if there’s a cheaper alternative,” suggested Warda.

Price Chopper pharmacies are giving away diabetes drugs

May 21, 2010 By: Nadia Category: Free Prescriptions, HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com source: www.timesunion.com – Cathleen F. Crowley, 5.19.2010

First, pharmacies slashed the cost of generic drugs. Then grocery stores such as Stop & Shop and Wegmans shot back with free antibiotics. Now Price Chopper is offering free drugs to people living with diabetes.
Competition for customers is fierce in the world of retail pharmacy, which is up against mail-order powerhouses.Price Chopper is the first grocery store pharmacy to provide free diabetic medications in the Northeast, according to Golub Corp., Price Chopper’s owner. Florida-based Publix Super Markets has a similar program.

“It’s a pretty business-savvy move,” said Craig Burridge, executive director of Pharmacists Society of the State of New York. “When you are dealing with a disease state that has other products that are not drug-related, you can make some money off of it.”

Price Chopper launched the program this week. Mona Golub, vice president of public relations and consumer services for the Schenectady-based supermarket chain, said it will build customer loyalty and address a major health problem in the community.

“From a business standpoint, Price Chopper’s interest is in establishing and solidifying a stronger relationship with our customers and becoming more of a comprehensive resource to consumers,” Golub said. “From a health perspective, the new Diabetes AdvantEdge program offers a comprehensive menu of resources and tools to those who are managing diabetes.”

Price Chopper, which has 70 pharmacies in six states, has already tailored programs for people with celiac disease by stocking more gluten-free products and providing gluten-free cooking classes. Golub said the store will continue to target niche groups.

For its diabetes program, Price Chopper will provide metformin, glipizide and glyburide free of charge to customers who have a doctor’s prescription for the drugs. The oral pills are generic drugs for controlling Type 1 and 2 diabetes, and are among the most commonly prescribed medications to diabetes patients. They are also relatively inexpensive.

Burridge said customers who use the program are likely to move all of their prescriptions to the grocery store’s pharmacy and buy accessories, such as blood testing supplies for controlling the disease, there also.

Consumers should review the cost of filling all their scripts before making a decision, said Burridge, who says consumers use one pharmacy for all their prescriptions.

“You don’t buy a car because you get free floor mats,” he said.

Price Chopper also will offer free one-on-one consultations with pharmacists and nutrition education for diabetic patients. Unlike a standalone pharmacy, the supermarket pharmacy has the advantage of offering a full range of products that diabetic patients need: sugar substitutes and low-calorie foods in addition to the blood testing supplies.

Golub said, “We will continue to look to connect meaningfully with groups of consumers that have unique needs that we can serve.”

Find a Price Chopper Pharmacy near you on www.medtipster.com.

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