Express Scripts to put specialty pharmas under the microscope, focusing on Teva & AbbVie
- Last week, Valeant severed its relationship with the specialty pharmacy Philidor Rx when allegations surfaced about phantom sales and manipulated transactions to "force" coverage of Valeant drugs.
- After those allegations surfaced, Express Scripts, as well as CVS Health and UnitedHealth Group's OptumRx, dropped all of their business with Philidor.
- Now, Express Scripts, the largest pharmacy benefit manager (PBM) in the U.S., is investigating the specialty pharmacies associated with Teva and AbbVie.
Not all specialty pharmacies are the same. Specialty pharmacies deal with insurers and also link patients to assistance programs, which then allow drug companies to help patients cover their out-of-pocket expenses. In fact, many patients rely on these pharmacies not only for initial transactions, but also support with insurers and help understanding how to use their medications.
In the case of Teva, the company's Shared Solutions program helps multiple sclerosis patients get started with Copaxone. But after that, Teva shifts fulfillment to a patient's standard pharmacy.
That's an example of how a specialty pharma should work. As the investigation into Philidor's practices continue, the hope is that Philidor is an outlier—and not an archetype.