* Senators say deals could push up health costs
* Give Dec. 21 deadline for details on arrangements
By David Morgan
WASHINGTON, Dec 1 Three leading U.S. senators
are inquiring into drugmaker Pfizer Inc's deals with
pharmacy benefits companies to limit the sale of generic rivals
to cholesterol drug Lipitor, which lost U.S. patent protection
Pfizer reportedly agreed to give discounts to pharmacy
benefits managers and health insurers on Lipitor provided they
blocked prescriptions to the generic alternative.
The drugmaker denies it has imposed such conditions, but is
offering discounts to these companies and patients as part of
an aggressive marketing strategy to hold onto as much income as
possible from the best-selling medicine of all time.
Lawmakers from three Senate oversight committees said the
arrangements could lead to limited access to generic drugs and
push up healthcare costs for medical patients and the
government insurance programs Medicare and Medicaid.
"Without the prospect of true competition, generic drug
manufacturers will be hesitant to invest the time and resources
required to bring low-cost generic drugs to the market," they
wrote in letters sent to Pfizer, Medco Health Solutions , Express Scripts , Catalyst RX ,
Coventry Health Care and UnitedHealth Group .
The lawmakers, Senate Finance Committee Chairman Max
Baucus, a Democrat; Senate Aging Committee Chairman Herb Kohl,
a Democrat and Senate Judiciary ranking Republican Charles
Grassley, wield considerable influence over issues involving
healthcare and industry competition.
Low-cost generic drugs are a key lever for controlling
healthcare costs, which in recent years have eclipsed the pace
of U.S. economic growth, inflation and household income.
The senators' request followed a Nov. 11 New York Times
article that said Pfizer had reached deals to prevent Lipitor
customers from having access to generics for the next six
months, before additional competitors come onto the market.
"We are concerned that the (benefits management companies)
may charge health plan sponsors, including employers and
Medicare Part D, full price for brand name Lipitor from Dec. 1,
2011 through May 31, 2012, while pocketing the discount from
Pfizer," the senators said.
The letter gives the companies until Dec. 21 to provide
details of their agreements from wholesale costs to
manufacturer discounts, consumer co-payments and the number of
people affected, as well as presentations made to corporate
officers including board directors.
"Our intent is to offer Lipitor to payors and patients at
or below the cost of a generic" in the next six months, Pfizer
said. "As a result, patients receive Lipitor at co-pays
comparable to generics. Participation in Pfizer's programs by a
health plan is entirely voluntary."
Express Scripts said in an emailed response to Reuters
that it does recommend generic substitution for Lipitor when
patients fill the subscription at retail pharmacies, but that
the final decision rests with the client, such as employers,
whose benefits it manages.
Express said that so far, just one of 2,100 clients has
chosen to block filling retail prescriptions with generic
Lipitor. It did not address its approach to generic Lipitor
when filling prescriptions via mail-order.
Lipitor, which soared to become one of the biggest-selling
drugs after its introduction in 1997, lost its patent
protection on Wednesday. The U.S. Food and Drug Administration
gave approval for the first generic version to Indian drugmaker
Ranbaxy Laboratories Ltd . Pfizer is also selling a
generic version of the drug, known chemically as atorvastatin,
in partnership with Watson Pharmaceuticals .