|CVS Caremark's Woonsocket, RI, headquarters--Courtesy of CVS Caremark|
When do rising drug prices not equal rising sales? When payers step in to control costs--and that's exactly what they've been doing. The latest: Express Scripts ($ESRX) and CVS Caremark ($CVS) are kicking two Horizon Pharma ($HZNP) drugs off their formularies as of Aug. 1--and plan to exclude them completely next year.
As Horizon noted in an SEC filing, the move to exclude Duexis and Vimovo, which treat arthritis pain, could cut the drugs' prescriptions by 20%-30%. And the exclusions may not end there, Horizon cautioned. If other healthcare plans follow suit, "there could possibly be additional Duexis and Vimovo prescriptions affected," it said.
Why the lost love for Horizon's pain-therapy duo? As Investor's Business Daily notes, it could have something to do with the fact that both are combo drugs whose ingredients are available as solo meds. Duexis comprises the pain reliever ibuprofen, the active ingredient in Advil and Motrin, and the heartburn remedy famotidine, a.k.a. Pepcid. Vimovo is another pain drug/stomach med combo, naproxen (Aleve) and esomeprazole (Nexium). All four are available as generics, with Nexium off patent as of May this year.
In the past, Horizon has found success through aggressive marketing and price increases--but those increases are what PBMs are increasingly looking to combat. The drug price debate has been loudest with Sovaldi, Gilead's ($GILD) next-gen hep C drug that runs $84,000 for a 12-week course of treatment. To keep the drug from decimating its bottom line, Express Scripts has put tight limits on reimbursement and lobbied doctors to hold off on treating some patients till competitors hit the scene and drive prices down. Read more in FiercePharmaMarketing >>