tag:blogger.com,1999:blog-9143719926358099859.post1685281310483197007..comments2023-10-26T08:08:43.486-07:00Comments on Dr. Mintz' Blog: Pharma & Pharmacy: CVS and Merck Team Up to Sell Drugs!Dr. Matthew Mintzhttp://www.blogger.com/profile/01058182168282244996noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-9143719926358099859.post-82679243716088912132008-12-14T13:54:00.000-08:002008-12-14T13:54:00.000-08:00A friend of mine received a similar letter regardi...A friend of mine received a similar letter regarding Fosamax, paid for by Merck and generated from Walmart pharmacy records. These are considered marketing communications and are exempt from HIPAA.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9143719926358099859.post-25698244441617799692008-11-03T13:58:00.000-08:002008-11-03T13:58:00.000-08:00RJS and Mr. Medsaver,Thanks for your posts. Yes, ...RJS and Mr. Medsaver,<BR/>Thanks for your posts. Yes, I understand that the letter was from the PBM, but this was a little too hard to explain in an already long post. That said, it is the same company. If pharma is partnering with the PBM, what's to stop them from partnering with the local drug store? Though I agree this is less likely to happen, "never" is a pretty strong word. <BR/>This is a very worrisome trend. I am not anti-Pharma, and I think they have a right to advertise their medications. However, I have a right to ignore these ads if I choose. By sending patient specific data through a pharmacy or PBM, I am now obligated to look at this information. In addition, since this is an advertisement disguised as clinical information, this is a very deceptive practice.Dr. Matthew Mintzhttps://www.blogger.com/profile/01058182168282244996noreply@blogger.comtag:blogger.com,1999:blog-9143719926358099859.post-12471454753933923812008-10-30T07:04:00.000-07:002008-10-30T07:04:00.000-07:00RJS,PBMs don't save money when generic drugs are d...RJS,<BR/><BR/>PBMs don't save money when generic drugs are dispensed because PBMs don't pay for the drugs to begin with. PBMs are nothing more than a "middle man" or "pass through." PBMs pay the pharmacy for a prescription, and then turn around and bill the health insurance plan (usually at a higher rate). PBMs have zero incentive to lower pharmacy costs-unless it makes them more money by increasing their spread, etc. Check out my blog for a more in-depth explanation: http://mrmedsaver.blogspot.com/2008/10/so-dark-con-of-pbm.htmlMr. MedSaverhttps://www.blogger.com/profile/06071747693415367446noreply@blogger.comtag:blogger.com,1999:blog-9143719926358099859.post-43180839955244754592008-10-29T16:32:00.000-07:002008-10-29T16:32:00.000-07:00"Will I be receiving promotional calls from my loc...<I>"Will I be receiving promotional calls from my local CVS pharmacy which seems like a professional to professional communication, but is really a disguised sales pitch?"</I><BR/><BR/>That will never, ever happen.<BR/><BR/>--<BR/><BR/>And don't be confused by the CVS-Caremark merger. You didn't receive this letter from the pharmacy, you received it from the PBM part of the company. And I'm surprised that they sent you a letter about a brand-name drug. Pharmacies make money on generic drugs, and PBMs save money when generic drugs are dispensed.<BR/><BR/>In this case, Januvia is far less expensive than either of the TZDs, which is probably why they prefer it.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9143719926358099859.post-54330491226902688252008-10-28T19:56:00.000-07:002008-10-28T19:56:00.000-07:00The fact that a pharmacy chain (CVS) and a PBM (Ca...The fact that a pharmacy chain (CVS) and a PBM (Caremark) have merged has you confused. But make no mistake about it . . . it was the "Caremark" part of CVS/Caremark--not the CVS part--that sent you this letter.<BR/><BR/>This is just another example of the types of tactics PBMs will employ to create revenue. Ever wonder why certain drugs in the same class will have lower copays than others? All ARBs, for example, cost about the same. However, Diovan might have a $30 copay, while Benicar will have a $50 copay on a certain insurance plan. Of course, you you probably have drug reps assault you at your office every day telling you that their drugs are on certain tiers of different insurance plans.<BR/><BR/>The reason for this lies in the fact that manufacturers will pay PBMs a rebate--that is often not passed on to the health insurance company--for such preferential treatment.<BR/><BR/>My guess is that Caremark is getting a high kickback from Merck whenever they process a Januvia prescription. Therefore, it's in Caremark's best interest to push this drug as much as possible. Of course, if the patient or the health insurance has to pay more for this, Caremark really doesn't care.Mr. MedSaverhttps://www.blogger.com/profile/06071747693415367446noreply@blogger.comtag:blogger.com,1999:blog-9143719926358099859.post-37168329854858214732008-10-28T19:19:00.000-07:002008-10-28T19:19:00.000-07:00I have gotten letters from insurance companies or ...I have gotten letters from insurance companies or their pharmacy benefit manager (i.e. Merck Medco) with patient specific data regarding refills of prescriptions. These are the insurance company's way of telling me my patient is not taking their medication regularly or taking to much (i.e. narcotics, sleeping pills, duplicate prescriptions). This information is sometimes helpful. <BR/>I have gotten mailings from CVS with generic advertising of their services, but not marketing a specific drug. I have gotten TONS of mailings from various drug companies promoting their products (on average 3 a day). However, I have never gotten patient specific data from a pharmacy (CVS) that was funded by a drug company that promoted a specific drug. <BR/>Januvia is much more expensive than metformin, but to me this is not really the main issue. Januvia is by enlarge a second tier co-pay, meaning that for my patients (who all have insurance) the cost is about $20. A mentioned in the orginal post, I think Januvia is an appropriate drug for some diabetic patients (most who can not be controlled on metformin alone). My concern is with the drug company getting to the doctor with patient specific data through the pharmacy, bypassing patient confidentiality. If I get a advertisement from the drug company, I can look at it or ignore it. However, when I receive information about my patient from another health care vendor, I am morally (and I think legally) obligated to look at this. There is good data to suggest that drug company advertising is effective. Is it more effective if it is patient specific? I would think so.Dr. Matthew Mintzhttps://www.blogger.com/profile/01058182168282244996noreply@blogger.comtag:blogger.com,1999:blog-9143719926358099859.post-53972359811599624032008-10-28T11:44:00.000-07:002008-10-28T11:44:00.000-07:00Ed, for reference according to Lexi-Comp one month...Ed, for reference according to Lexi-Comp one month of Januvia costs $190.00 and one month of a standard dose of Metformin, generic is about $12.00.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9143719926358099859.post-28324829582236347762008-10-28T10:34:00.000-07:002008-10-28T10:34:00.000-07:00Hi Matt,So you're saying you've never received suc...Hi Matt,<BR/><BR/>So you're saying you've never received such a letter before? And any idea whether your patient would have had coverage for Januvia at a comparable rate to whatever you had prescribed? Would it be fair to say the Merck pill is generally more expensive?<BR/><BR/>Regards<BR/>ed@pharmalot.compharmalothttps://www.blogger.com/profile/17832964879919197471noreply@blogger.com