A study by Express Scripts, the pharmaceutical benefit manager, said that an analysis of 220,000 patients found that 23percentt of those who fell into the doughnut hole in 2006 could have skirted it by using generics to cut drug costs.
Aetna, seeking to stem rising prescription drug costs, said yesterday that it would end its mail-order contract with a pharmaceutical benefits manager, Express Scripts, and conduct the business itself.
Correction: October 25 , 2002 Friday A brief report in the Company News column of Business News yesterday about the elimination of a pharmaceuticals contract between Aetna and Express Scripts misidentified the company that reported quarterly results and had a drop of $1.16 in its stock price.
Democrats favor a larger role for the government, while President Bush and Congressional Republicans would rely heavily on competing private health plans and pharmaceutical benefit managers, like Express Scripts and Medco Health Solutions, a unit of Merck & Company.
Express Scripts analyzed several pharmaceutical interventions implicated in what some experts call the "medicalization of aging" — medications that treat hair loss, leaky bladders, wrinkling skin, insomnia, menopause (hormone replacement therapy), sexual dysfunction and less-than-optimal mental alertness.
"We're spending $35 billion on biologics in the U.S.; that number is increasing to $70 billion in the next thee years," says Mark Merritt, chief of the Pharmaceutical Care Management Association, which lobbies for pharmaceutical benefit managers like Express Scripts and Wellpoint.
The report adds the changes will affect Express Scripts's main formulary — PBMs like Express Scripts negotiate rebates from pharmaceutical companies in exchange for including that company's drugs on these formularies, or lists of drugs covered by insurers.
INVESTORS' NOTE: The biggest publicly-traded pharmaceutical supply chain companies include Express Scripts (NASDAQ ESRX), AmerisourceBergen (NYSE ABC), Cardinal Health (NYSE CAH), and McKesson (NYSE MCK).
"They are setting up a Pfizer pharmacy, if you will," said Everett Neville, vice president of pharmaceutical strategy and contracting at Express Scripts., one of the nation's biggest pharmacy benefit managers.
In the case of H.P. Acthar Gel, an injectable anti-seizure medication derived from hog hormones, the fourteenfold price increase came after the maker, Questcor Pharmaceuticals, gave exclusive distribution rights to Express Scripts' CuraScript unit last summer.
