Why Exclude Valeant’s Glumetza?

Jan 29, 2016
By excluding Valeant’s Glumetza from our formulary, Express Scripts will be leveraging market competition to lower drug costs and keep medicine within reach of the patients who need it.
  • Diabetes

Together with our clients, Express Scripts has changed the industry by holding pharmaceutical manufacturers accountable for excessive price hikes that put medicine out of reach for those who need it.

Valeant’s Strategy to Maintain Market Share Despite Skyrocketing Prices and Generic Competition

Valeant Pharmaceuticals International increased U.S. prices on more than 60 of its drugs by at least 50% in 2014. Last year, Valeant continued this strategy with the highest average drug price increase in the industry – 65% across 50 products. One product in particular, Glumetza® (metformin HCL extended-release tablets), experienced a price jump greater than 800% in 2015.

On Monday, February 1, a more affordable generic equivalent to Glumetza will be available in the U.S. But recent agreements Valeant has signed with retail pharmacies now potentially encourage the pharmacies to bypass the more affordable generic metformin and instead dispense branded Glumetza at a higher cost to American payers.

The Need for a Formulary Exclusion

Our legacy of independence as a standalone pharmacy benefit manager means we’re committed to doing what’s right by our clients. Full alignment matters, especially when it comes to controlling the cost of prescription drugs.

To protect our clients and patients from wasteful, unnecessary drug spend, Express Scripts will exclude Glumetza from our 2016 National Preferred Formulary, pending FDA approval of the generic equivalent. In addition, our clients that maintain other formularies will have the option to also exclude the branded product.

By excluding Glumetza from these formularies, Express Scripts clients are ensuring that their patients be dispensed the more affordable generic formulation of metformin. Branded Glumetza will not be allowed to process, even at retail pharmacies that have signed agreements with Valeant to prioritize the dispensing of Glumetza.

Formulary exclusions like this one have saved our clients more than $3 billion over the past three years. These exclusions are clinically sound, affect fewer than 0.5% of our patients, and are coupled with a pathway for medical exceptions in the rare cases where the physician deems the excluded drug to be necessary.

Taking Action Now to Curb Future Healthcare Waste

When manufacturers like Horizon Pharma PLC purchased the rights to old generic medications and immediately hiked the prices by more than 500%, we removed those products from our formulary. When certain compounding pharmacies began exploiting a loophole to increase the average prescription cost of a compound from $90 to $1,100, we took the industry’s most aggressive stance to block clinically unnecessary ingredients. When Gilead Sciences announced that it would sell its hepatitis C product for $1,000 per tablet, we ultimately used industry competition to save the country an estimated $4 billion this year. And when the price of Daraprim jumped 5,000% overnight, we championed a $1 alternative.

As we have repeatedly demonstrated, Express Scripts will always leverage market competition to lower drug costs and keep medicine within reach of the patients who need it. We did it by removing Valeant’s captive pharmacies from our network, and we’re doing it again by excluding Valeant’s Glumetza from our formulary.

Agreements between certain pharmaceutical manufacturers and retail pharmacies are likely to continue. Express Scripts will closely monitor these arrangements and will take swift action in the instances when the agreements run counter to the best interests of the clients and patients we represent.

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Lab Staff
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