Another Reason Your Prescription Costs So Damn Much. Medco Wants A Chunk Of Your Lipitor.

The whole idea of a Pharmacy Benefit Manager is that it will save an insurance plan's sponsor money. I mean, why the hell else would you hire a company to do something for you if it ends up costing you more than it would take to do it yourself? "Let us take care of the pharmacy end of your insurance plan" the PBM's say. "We know the ins and outs of the pharmacy business and can drive a hard bargain with drugstores." It's the whole reason they exist. To create savings and pass them along to the plan sponsor. Keep that in mind as we talk about this article from Friday's New York Times:

The biggest introduction of a generic drug in pharmaceutical history is being met with tough business strategies by Pfizer and pharmacy benefit companies, according to recent letters to pharmacists. Many drugstores are being asked to block prescriptions for a generic version of Pfizer’s Lipitor starting Dec. 1, when the company loses its patent for the blockbuster cholesterol drug and generic competition begins. Medco Health Solutions, among the nation’s largest pharmacy benefit managers, is one of the companies issuing instructions, seeking to have pharmacists keep filling prescriptions with the more expensive Lipitor for six months.

What? Has Medco lost its mind? Requiring pharmacies to use a more expensive drug? "Medco must be stupid" Some of you are probably thinking.

Pfizer has agreed to large discounts for benefit managers that block the use of generic versions of Lipitor, according to a letter from Catalyst Rx, a benefit manager for 18 million people in the United States. The letters have not previously been made public. 

"Oh my gosh! Medco isn't stupid, Medco is smart!" You're now saying. "After anal raping drugstores to the point where they have nothing left to give, Medco is going after the drugmakers and negotiating discounts! They really will be giving value to plan sponsors when they pass all those savings from Pfizer along!"

To which I will say..........BBBBBWWWAAAAAAHAHHHAAAHHHAAAHHAAAAAAA!!!!! You obviously don't know PBM's very well:

A pharmacy group and an independent expert say the tactic will benefit Pfizer and benefit managers at the expense of employers and taxpayers, who may end up paying more than they should for the drug. “I’m stunned,” said Geoffrey F. Joyce, an associate professor of pharmaceutical economics and a health policy expert at the University of Southern California, after reviewing the letters. “This is just an egregious case. Clearly there’s been some negotiation between Pfizer and the large P.B.M.’s saying we’re going to make this cost-beneficial to them, but the plan sponsors are going to eat it.” 

"Eat it" in this case, is a polite way of saying "take it up the ass"

Objections to the deal were raised publicly on Thursday in a news release from a group called Pharmacists United for Truth and Transparency, which opposes some tactics of pharmacy benefit managers. The statement called the move “a blatant attempt” by benefit managers to keep Pfizer’s discount while employers still have to pay the full price of the brand-name drug. 

Got that? Medco negotiated a discount from Pfizer alright, and evidently is planning on keeping it all to itself. Now I only had a few business electives in college, so maybe an MBA out there somewhere can explain to me how that's not a kickback.

But is Medco really planning on something so brazen? Why don't we just ask them directly:

Melissa Mackey, manager of public affairs for Medco, said its letter described “a custom plan design, which is not a new concept,” in which clients could “tailor their formulary to maximize value.”

That, my friends, is a textbook case of corporate bullshit. You ever need an example of how to talk without saying anything, you just go back to that quote. Why don't we try just asking them a simple question that requires a simple answer:

Asked in an e-mail specifically whether Medco would pocket the Pfizer discounts while employers and taxpayers paid more than the generic price for brand-name Lipitor, Ms. Mackey declined further comment.

Yup. Think we have our answer. And I'm thinking we can expect more of the same when Medco merges with Express Scripts and controls a third of the market.

Tell me again why I'm supposed to be afraid of socialized medicine?
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Another Reason Your Prescription Costs So Damn Much. Medco Wants A Chunk Of Your Lipitor.
Another Reason Your Prescription Costs So Damn Much. Medco Wants A Chunk Of Your Lipitor.
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