Labor Group Accuses CVS of Pushing Expensive DrugsNov 14, 2008 | Parker Waichman LLP
The Wall Street Journal (WSJ) is reporting today that some labor unions have banded together under the name “Change to Win” to initiate “a campaign that accuses CVS Caremark Corporation of violating patient privacy and improperly pushing doctors to prescribe a costly prescription drug.” Change to Win “represents about six million workers,” said the WSJ.
Change to Win, according to the WSJ, is outraged over a move made earlier this year by CVS Caremark’s pharmacy benefits group in which a letter—paid for by Merck and Company—was urging doctors to move certain patients to the Merck’s drug, Januvia. Januvia is a brand name treatment for type 2 diabetes. It seems, said the WSJ, that CVS obtained the patient listing after conducting “a review of prescription-drug claims processed by its Caremark unit.” The WSJ piece points out that “neither Merck nor CVS would say how much Merck paid, and the drug maker also declined to say whether the mailing boosted Januvia sales.” Also according to the WSJ, a recent study placed Januvia costs as being “as much as eight times more expensive than many other diabetes treatments,” a fact only worsened by “some medical experts” pointing out that “patients may not need the drug and may respond just as well to older, cheaper treatments.”
The WSJ piece refers to an earlier piece that ran this summer in the Phoenix Business Journal in which that publication noted something we have also long been reporting on: The ubiquitous giving of promotional gifts by drug makers to physicians. The Phoenix Business Journal pointed out that, because of the change in gift-giving policy, some drug makers are utilizing more creative ways to market. In some cases, such drug makers are culling patient data and using that to “suggest” to physicians which drugs to use for which illnesses, says the paper. But, according to the Phoenix Business Journal, not all doctors are happy about how a CVS Caremark pharmacy benefits manager sent letters to some doctors in Arizona, pushing Januvia for use in certain patients. The letters included “patients' names, birth dates and identification numbers, along with the names of the drugs they are taking,” said the Phoenix Business Journal. The piece noted that Merck paid for the mailing, which begs some questions, said the Phoenix Journal. One source questioned if CVS used “data to show how doctors could replace expensive drugs with generic versions” and was particularly concerned that CVS was “marketing … with a brand-name medication.” According to that paper’s source, the inference was that “CVS Caremark is making money from drug companies by distributing this material."
The WSJ cites what many physicians had been most concerned about and which Change to Win is also now stating, that the letter shows how “CVS” is “putting its interests ahead of the businesses that pay it to manage employee prescription-drug benefits.” According to the WSJ, CVS entered the pharmacy-benefits management (PBM) after acquiring Caremark, which was the “nation's second-largest PBM.” And, as the WSJ points out, PBMs have long “been accused of favoring drugs that generate rebates and high profit margins.” For instance, in 2002, Longs Drug Stores—in a Merck-funded mailing—urged “patients to switch to a new version of the osteoporosis treatment Fosamax,” said the WSJ.