Keeping a lid on spending has seemingly gotten lost in the health care overhaul, David Whelan of Forbes writes. But could insurers be wising up when it comes to me-too drugs?
Whelan takes a look at Nexium, the AstraZeneca heartburn drug. It was the follow-up to Prilosec, a tweaked version of the original. To support Nexium's launch, AstraZeneca raised prices on Prilosec, hoping to steer patients toward the new drug. And for several years most insurers paid for it happily. But a number of insurers have cut it off the formulary, saving money in the process.
For example, Edward Kaplan, a New York City health care consultant, last year advised a Boston union representing supermarket workers to stop covering Nexium, saving $133,000. At $2,000 for a year's supply, it was the union plan's second-most-prescribed pill, accounting for 5 percent of all drug costs, Whelan notes.
Plenty of drugmakers have followed AstraZeneca's strategy: Tweaking a successful drug, then hiking prices on the original to get patients to switch. UnitedHealth has gone after one of the others: Clarinex, the Schering-Plough allergy pill that followed up the highly successful--and now off-patent--Claritin. But UnitedHealth had enough, knocking other high-cost, low-value drugs out of its formulary, including Clarinex and Pfizer's growth hormone Genotropin.
With folks at Medco Health Systems doing their own comparative research--and insurers looking to cut costs wherever they can--more of those changes could be on their way.