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PHARMA: PBM plays tough with A-Z’s Crestor

Oops…for some reason this didn’t "publish" late last night…..

In a report out of The Delaware News Journal comes interesting news about the statin wars. The ACC meeting this week has lead to the release of a host of studies concluding that "stronger is better" in terms of the health effects of statins. Although bloggers Sydney Smith at Medpundit and Robert Centor at Medrants disagree on the exact significance of the PROVE-IT study, all concerned seem to believe that stronger is more or less better. Crestor from A-Z is usually believed to be the strongest statin, yet the folks at Medco, the nations biggest PBM have followed the lead of Wellpoint, one of the biggest health plans (and the most influential in terms of Rx trends) by leaving Crestor off its formulary listing. AdvancePCS, which is about to be the other big PBM gorilla after its pending merger to Caremark is complete, has put Crestor high up on its formulary.

So in the real world, will the dogs eat the dog food if they have to pay more for it? Astra-Zeneca is about to find out. Despite the carnage in the market lately, their stock is still doing fine. But the news from three-tier formulary land is not good, as an off-formulary position usually means that people won’t pay the extra for the non-preferred branded Rx.

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