Dive Brief:
- Pharmacy benefits manager Express Scripts is paying extra attention to prescription claims for products from Valeant Pharmaceuticals, chief medical officer Steve Miller told Bloomberg.
- The scrutiny comes in the wake of heavy criticism of Valeant's pricing strategies. Memos released by the House Oversight Committee before a hearing in early February showed Valeant bought the rights to two old cardiovascular drugs—Isuprel and Nitropress—and immediately raised prices by 525% and 212%, respectively.
- In his comments to Bloomberg, Miller said many of Valeant's products are highly priced despite the availability of generics. Valeant originally came under scrutiny when allegations surfaced over phantom sales to the now defunct specialty pharmacy Philidor.
Dive Insight:
Last week, Valeant's seemingly contrite interim CEO Howard Schiller admitted to the House Oversight Committee that Valeant had "made mistakes." He said the company would not pursue as drastic price increases going forward.
Outside of the questionable business practices involving Philidor, Valeant has ignited criticism by raising the prices of 13 drugs by more than 100% since December 2014. Express Scripts appears to be pushing back against Valeant's price increases
The mega-PBM already dropped Valeant's diabetes medication, Glumetza, when its price rose by 800% in 2015. Express Scripts blocked reimbursement of the drug on February 1st, the day a generic version became available.
Beyond pledging to restrain from overly aggressive pricing, Valeant has sought to mitigate criticism by offering discounts to hospitals. For example, the company has offered discounts to hospitals of up to 30% for Isuprel and Nitropress.
Pharmacy benefits managers have taken on an increased influence in the ongoing drug pricing debate, using their formulary power to negotiate for discounts and push for cheaper drugs.