Express Scripts puts heat on pharma with new price hike-fighting program

Express Scripts HQ

Express Scripts ($ESRX) is taking its fight against rising drug prices up a notch. The PBM is rolling out a program that targets price hikes on older drugs, responding to moves from companies such as Valeant ($VRX) and Turing to jack up prices for certain therapies.

Express Scripts new “market events” program allows the PBM to “act within weeks, instead of months or longer,” when a company jacks up prices or tries to shift patients to more expensive therapies, CMO Steve Miller told Bloomberg. The effort “sends a message to the marketplace that we are prepared to respond very quickly to these things,” Miller said.

The program will be optional for Express Scripts’ employer and health-insurer clients. Customers that sign up will give the PBM advance permission to move patients to cheaper alternatives when an old drug’s price increases, Miller told the news outlet. Express Scripts will also be able to push patients away from pharmacies that are doling out pricier meds instead of cheaper therapies.

Price increases on older meds “have been popping up at a more frequent pace,” and for companies hiking prices, Express Scripts’ program “is going to challenge their business model,” Miller said. If all goes to plan, the PBM will launch the program later this year.

Express Scripts has made no bones about its feelings about drug price increases from companies such as Valeant and Turing. And the PBM giant has already taken steps to push back.

Last year, Express Scripts backed a cheaper, compounded rival to Turing’s toxoplasmosis drug Daraprim after the company bought that drug and jacked up its price by more than 5,000%. Earlier this year, the PBM blocked reimbursement for Valeant’s diabetes med Glumetza; the company had jacked up the price by 800% in 2015, Express Scripts has said.

Express Scripts is also planning to beef up one of its previously announced drug price-fighting programs, Miller said. The PBM last year said it would introduce a value-based reimbursement model that uses indication-specific pricing to favor “clinically superior” therapies.

The PBM has already applied this tactic to certain cancer meds, but Express Scripts plans to expand the program at the beginning of 2017 to include anti-inflammatory drugs, Miller said. The move could have a big impact on AbbVie ($ABBV) and Amgen ($AMGN), whose Humira and Enbrel bring in big dollars for the drugmakers. “We believe there is going to be substantial savings here,” Miller said.

- read the Bloomberg story

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