Medco Health Solutions ($MHS) and Catalyst Rx may not be the only pharmacy benefits managers with clients blocking Lipitor generics in favor of Pfizer's ($PFE) branded version. As Bloomberg reports, the drugmaker is negotiating to add Express Scripts ($ESRX) to the list. Pfizer's aim, says Watson Pharmaceuticals ($WPI) CEO Paul Bisaro, is to hang onto 40% of Lipitor sales over the first 6 months of generic competition, instead of the typical 10%.
"We have had discussions with Pfizer," Express Scripts spokesman Brian Henry told Bloomberg, adding, "Pfizer has offered similar deals in the marketplace."
As reported earlier this week, insurer Coventry Health Care will give its members access to branded Lipitor rather than generic versions, and with the same generic-level co-pay. Pfizer spokesman Mackay Jimeson told Bloomberg the company is offering branded Lipitor at a competitive price. "Total costs to payers are less than a generic option and patients receive Lipitor at co-pays comparable to generics," Jimeson said.
Medco will be administering Coventry's deal with Pfizer, and it's also planning to offer branded Lipitor at generic-level prices as exclusivity expires Nov. 30. Medco's mail-order pharmacies will dispense the branded drug as their "house generic"--even if patients have a prescription for copycat Lipitor--partly because of uncertainties about generic availability, Medco spokesperson Jeff Simek told us via email. Ranbaxy Laboratories, which has the exclusive right to sell an independent generic version beginning Dec. 1, has ongoing problems with the FDA that must be settled before it can market its Lipitor copy.
"As supplies of a third-party generic are available, we will begin dispensing this for clients who have a specific preference for that third-party product," Simek said, "but in either case, the member benefits from the lower generic co-pay and the plan receives the discounted pricing."
Pfizer's deep discounting and PBM dealmaking is a high-stakes proposition: If the company can indeed keep Lipitor sales flowing at 40% through May, it would garner about $932 million off the drug in 2012, compared with just $233 million at the usual 10% rate, Sanford C. Bernstein analyst Tim Anderson said.
- read the Bloomberg story