As Competitors Encroach, Pfizer Seizes A Few More
Google “Lipitor” and “discount,” and you’ll see
print coupons are the least common discount. Nowadays
free-for-all Internet capitalism at work. Of course, not all
copayment cards are much more prevalent. Hence the $4
of the 3.18 million hits lead to a legitimate manufactur-
Lipitor offer currently blanketing cyberspace.
er’s discount for Pfizer’s wonder drug, but thousands
“Copay-assistance programs seem to be the most
do. And the vast majority of those simply are tapping
popular type of discount for patients,” Ric Gross, a mar-
the immense popularity of Lipitor (atorvastatin) to redi-
ket analyst at Nashville-based health care information
rect traffic through their own websites, trying to waylay
company HealthLeaders-InterStudy, tells DBN. “These
visitors on their way to Lipitor.com, Pfizer’s proprietary
tend to cover all out-of-pocket patient expenses for the
site for the cholesterol-lowering drug. There, visitors
find the wellspring of a drug promotion gone viral, the now-ubiquitous $4 copayment card. Just fill out the
A New Level of Competition
online form, wait for your card in the mail, and receive
Unsurprisingly, pharma companies don’t offer plan
every 30-day prescription fill of Lipitor for just $4, up to
sponsors the same financial assistance, and some experts
$600 in savings per year. Pfizer picks up the rest.
submit that deep copay discounts woo consumers at
If only it were that simple. Faced with generic com-
the expense of other players in the health care system.
petition in November, Pfizer is trying to corner as much
“Payers are concerned that copay cards incent consum-
market share as it can for its hugely successful drug,
ers to use higher-cost drugs,” George Van Antwerp,
which lowers low-density lipoproteins (LDL) and tri-
general manager of pharmacy solutions for Silverlink
glycerides. Pfizer’s $4 copay program is a case study on
Communications, tells DBN. “The consumer no longer
how far drug makers are willing to go to gin up sales and
sees the penalty of using a more expensive drug.”
brand loyalty when their patent expiries are imminent.
Up until its patent expired and a licensed generic ap-
But too-good-to-be-true promotions generally are, critics
peared on the horizon, Lipitor had followed a by-now-fa-
charge. Tempted by free or near-free medications, con-
miliar life-cycle for successful drugs. “Pharma companies
sumers go on buying sprees, leaving third-party payers
tend to promote a drug heavily when it’s first introduced
and, ultimately, plan sponsors to pick up the tab.
to the market,” Gross says. “That means more reps going
Coupons, cards and other discount promotions fall
to talk with docs. As time goes by, the docs become more
into a gray area for many PBMs and health plans. “We
familiar with the drug, and the drug’s efficacy becomes
have two different perspectives on coupons, depending
more apparent. At that point, focus shifts more to health
on how they are used,” Everett Neville, chief trade rela-
plans regarding things like formulary placement and
tions officer for Express Scripts, Inc., tells DBN. “One,
they can be used to subvert the formulary and cause the
Pfizer, who declined to comment for this article, has
patient to not adhere to the formulary. That’s bad for the
given some indication that it will continue the $4 copay
whole industry. However, if it’s being used to alleviate
card only until November, when a generic version hits
the financial difficulties of acquiring a drug, it’s not nec-
the market, but Van Antwerp says he’d be surprised
essarily a problem.” Which category a particular coupon
if the company did not extend the offer. “Back when
deal comes under, though, can be ambiguous because
Zocor went generic, Merck actually made the brand drug
the use of a coupon or copay card by a consumer circum-
cheaper than the generic drug,” Van Antwerp recalls.
vents the normal PBM transaction, making research and
“United and a few other payers ended up putting brand
name Zocor into the generic tier on their formulary.”
Coupons and rebates used to be among the most
When a brand drug goes up against generic compe-
alluring drug promotions targeted at consumers, but
tition, Express Script’s Neville says, to be competitive,
manufacturers have adopted more sophisticated means
manufacturers may lower the price of the brand any-
of driving utilization. Neville says that in his experience,
where from 10% to 70%, “depending on the dynamics
Copyright 2011 by Atlantic Information Services, Inc. Reprinted with permission from Atlantic Information Services, Inc.,
1100 17th Street, NW, Suite 300, Washington, D.C. 20036, 202-775-9008, www.AISHealth.com
of the particular drug.” Since an established drug like
Contact Neville via Thom Gross at rtgross@express-
Lipitor has earned the costs of getting to market many
scripts.com, Gross via Erin O’Leary at eoleary@hl-isy.
times over, there is little obstacle to Pfizer dropping its
com and Van Antwerp via Marit Davies at mdavies@
price to compete with generics, setting up a whole new
Copyright 2011 by Atlantic Information Services, Inc. Reprinted with permission from Atlantic Information Services, Inc.,
1100 17th Street, NW, Suite 300, Washington, D.C. 20036, 202-775-9008, www.AISHealth.com
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