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Rite Aid Corporation Message Board

  • itsjustfred itsjustfred Mar 24, 2000 1:29 PM Flag

    Investigation article (cont 2)

    Gathering follow-up information for specific
    switch programs "is not a bad idea at all," Toan said.
    It would be "probably best done on a selected
    basis," he suggested: a switch between the competing
    lisinopril brands (Prinivil and Zestril) is unlikely to need
    monitoring, while a program involving new therapeutic classes
    may require more careful tracking.
    Comments by
    Sheehan suggest that any form of rebate may be suspect.

    Sheehan cited the terms of the 1996 pharmacy class action
    settlement, which requires the settling manufacturers
    (including Schering-Plough) to offer equivalent rebates for
    equivalent effects on market share. "When I start seeing
    rebates for movement of market share, I have more
    problems" with pharmacy interventions, Sheehan declared.

    Toan defended the rebate system: "The formulary and
    rebating process is a free-market activity to establish a
    fair price for the drug....It is a logical extension
    of a free-market approach."
    Express Scripts
    pointed out that the PBM business model can be found at
    every level of government from state Medicaid programs
    to the Veterans Affairs health system and the
    Federal Employees Health Benefit Plan. Given the interest
    in using PBMs to manage a Medicare prescription drug
    benefit, the PBM model appears to have a "fair amount of
    acceptance" even "at the highest level of the federal policy
    During the National Congress on
    Pharmaceuticals, Sheehan suggested that the interest in a PBM role
    in Medicare will lead to "a whole new role of
    regulation as opposed to prosecution." As "Congress becomes
    aware of these issues, I don't think they are going to
    sign on to a $20 bil. a year drug program" without
    addressing them, Sheehan declared.
    One PBM development
    that Sheehan indicated support for is the move towards
    the use of physician connectivity to eliminate
    pharmacy interventions altogether. As a result of his
    investigation, Sheehan predicted, "a lot of therapeutic
    interchange" will be pushed "to the front end and make it more
    an academic detailing context and less a five guys
    in a boiler room making phone calls 3,000 miles
    Express Scripts is an enthusiastic
    participant in the race to develop physician-based
    interventions (see related story, p. 15).
    In August,
    Sheehan projected that a case would be brought within a
    year. A common prosecutorial tactic is to find a
    potential defendant who may be more willing to settle
    because of a pending business transaction. PCS , which
    Rite Aid is eager to sell, is one logical candidate.
    If Schering-Plough decides to pursue a merger ahead
    of the Claritin patent expiration, it could also
    make an inviting target.

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