Union: CVS flogged costly med for Merck

A group of labor unions are in a tug-of-war with CVS Caremark's pharmacy benefits management, and a Merck diabetes drug stands right in the middle of it. The unions say CVS pushed doctors to prescribe Januvia to specific patients, violating patient privacy and potentially boosting drug costs.

In a letter to physicians obtained by the union group, CVS promoted Januvia, and said it had identified appropriate patients for the drug via a review of prescription drug claims processed by Caremark, its PBM unit. At the bottom of the letter, one line of type says Merck paid for the mailing, the Wall Street Journal reports.

The WSJ points out that Januvia is as much as eight times more costly than other diabetes treatments and that some experts say patients may respond just as well to the older, cheaper meds. The union group claims that CVS's promotion of the expensive alternative shows that the company is putting its interests ahead of the businesses that hire it to manage their pharmacy benefits. As you know, companies hire PBMs as a cost-control tactic.

For its part, Merck says that it didn't get any personal patient information for the mailing. It paid to send the letter "to help inform physicians about additional treatment options," a spokeswoman told the WSJ.

The union group, Change to Win, is publicizing the CVS letter as part of a campaign to change laws governing the way PBMs operate.  The group wants legislation to require PBMs to keep patient info private, to disclose discounts and rebates from drugmakers and to require that drug-switching result in cost savings for the PBM customers.

- read the WSJ story