Treximet: Cautionary tale of payer price revolt

GlaxoSmithKline's migraine medicine Treximet has been getting the cold shoulder from docs and insurers, Bloomberg reports. UnitedHealth, for instance, refuses to pay for the med on most of its plans. Why? Treximet combines the anti-inflammatory naproxen with Glaxo's migraine pill Imitrex--both of which are available in generic form. As a branded med, Treximet costs $18 per pill. The two generics together soon will cost around $5 a dose.

Is this the shape of things to come for combo pills in general? Even if they're approved by FDA, will they run into roadblocks from payers? The Bloomberg piece suggests it's so--and that the same fate is befalling other new-and-slightly-improved meds drugmakers often introduce to combat generic competition.

"There is nothing in Treximet that one can't get for significantly less dollars," Heady said in a telephone interview. "There are instances where drugs are being brought to market that really aren't different or offering any real benefit from a clinical or cost perspective. In those instances, it makes sense not to cover the drug at all."

Glaxo maintains that Treximet's whole is greater than the sum of its parts. But the company acknowledges it's having difficulty competing with generics because of cost pressures. Even doctors are getting in on the act; one headache specialist told Bloomberg that he asks patients about their co-pays on Treximet, and if the payments are high, he doesn't recommend it--unless he has a coupon.

- read the Bloomberg piece

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