Managed Care Matters

Express Scripts Alters Rebate Policy

From Drug Benefit Trends®
Posted 05/23/2003

Introduction

Express Scripts, St Louis, said it will no longer accept rebates from pharmaceutical manufacturers for promoting specific products to physicians and patients. However, the PBM will continue to take rebates from manufacturers that are based on increasing drug sales and market share.

The new policies are part of an Express Scripts Client Pledge issued March 17 by Express Scripts. These new policies will become effective October 1.

"As we enter an era of increased business accountability, the Express Scripts Client Pledge manifests our open and sustainable business model and reiterates for our clients and their members that we are unequivocally on their side in making the use of prescription drugs safer and much more affordable," said Barrett Toan, chief executive officer of Express Scripts.

"Express Scripts' business model aligns our interests with those of our clients and drives out conflicts of interest," Toan explained. The safety, efficiency, and availability of 24-hour pharmacist consultation in the mail pharmacy, as well as monitoring members' prescription drug use to identify possible safety concerns, were among the topics discussed in Express Scripts' business principles statement.

The Express Scripts Client Pledge "reaffirms alignment of the company's interests with those of its clients and members, respect for the physician's prescribing authority, and commitment to developing clinically sound formularies based on evaluations of independent physicians."

Specifically, Express Scripts pledges to:

  • "Always align our interests with those of our clients and their members.

  • "Develop clinically sound formularies based on evaluations of independent physicians.

  • "Aggressively promote the use of generic drugs.

  • "Support the use of clinically appropriate lower-cost brand-name drugs.

  • "Never recommend switching a member to a higher-cost drug.

  • "Provide our clients with a detailed disclosure of our sources of revenue and financial relationships with drug manufacturers.

  • "Always respect the physician's prescribing authority."

In an accompanying statement of its business principles, Express Scripts stated, "Our recommended formularies promote lower-cost brand drugs, and we do not recommend therapeutic (brand-to-brand) substitutions to more expensive drugs. Whenever we recommend a specific therapeutic substitution, the recommended drug will be lower cost."

Express Scripts acknowledged that it currently receives other payments from pharmaceutical manufacturers that support formulary inclusion of specific drugs but stated that these programs will be completely phased out by October 1.

Drug Benefit Trends 15(4):16-17, 2003.

© 2003 Cliggott Publishing, Division of SCP Communications
Copyright © 1994-2004 by Medscape. 

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