- Federal prosecutors have subpoenaed Horizon Pharma, requesting information about its patient assistance program, the Dublin-based company disclosed in a SEC filing Monday.
- Conducted by the U.S. Attorney’s Office for the Southern District of New York, the investigation is examining the HorizonCares program, which helps reduce patient out-of-pocket costs for prescriptions filled at independent pharmacies.
- Both Express Scripts and CVS Health recently stopped covering two of Horizon's main drugs, Vimovo and Duexis, because of the availability of cheaper alternatives. As pharmacy benefit managers (PBMs) clamp down on prices, Horizon Pharma and others have relied on patient assistance programs to boost adoption of their own drugs.
In fall 2015, Valeant severed its relationship with the specialty pharmacy Philidor Rx after allegations surfaced about phantom sales and manipulated transactions to "force" coverage of Valeant drugs. Ever since, the relationships between pharma companies and specialty pharmacies has come under heavy scrutiny.
Horizon Pharma is the latest company to be caught in the cross-hairs of this controversy. The recent federal inquiry has put pressure on Horizon stock despite a positive fourth-quarter earnings report in which Horizon reported a $24 million profit, compared with a $31.6 million loss for Q4 2014.
The HorizonCares program provides financial assistance to patients who need help covering out-of-pocket expenses and is a key part of the company's commercialization strategy. In its SEC filing, Horizon warned PBM pressure to switch patients to generics could lower patient adoption of its drugs, unless the company is able to increase use of HorizonCares.
Specialty pharmacies in question
However, only certain pharmacies participate in the HorizonCares program. Similar to last year’s investigation of Valeant and Philidor, the federal probe into Horizon will examine its relationship with other specialty pharmacies.
Horizon made sure to note in its filing that “all pharmacies that fill prescriptions for our medicines are fully independent, including those that participate in HoirzonCares.” Yet the company pointed to the negative publicity around specialty pharmacies as a potential risk factor driving physicians away from its patient assistance program.
Vimovo price increases
In late 2013, Horizon Pharma bought Vimovo from AstraZeneca. By January 1, 2014, Horizon had increased the price of Vimovo by 594% to nearly $1,000 per 60-tablet bottle. One year later, Horizon again hiked the price, this time to $1,678.32.
Correspondingly, Vimovo sales jumped to $163 million in 2014 from $20 million the year before. In its recent earnings, Horizon reported $167 million in 2015 sales.
Vimovo is a combined formulation of naproxen and esomeprazole, two generic drugs.