Association of ameritech/sbc retirees® blue bulletin

AT&T Ameritech /SBC Retirees - We are AASBCR®
Blue Bulletin
Vol.7 No.4
February 28, 2012
Proudly working on behalf of retirees of the Bell System and successor companies of the
Lipitor, a prescription for controlling cholesterol Part II

This is part II of the Lipitor vs. generic Atorvastatin bulletin (see the
AASBCR® Blue Bulletin dated 2-22-2012). As reported in Reuters… "As
cholesterol fighter Lipitor went generic, its maker Pfizer Inc hopes to hold
onto perhaps a third of the 3 million Americans who take the biggest-selling
drug of all time. Lipitor lost its' U.S. patent protection on Wednesday,
November 30, 2011. Pfizer is employing unprecedented tactics to hold onto
as many Lipitor prescriptions as it can during the first six months of generic
competition. Pfizer said it reached deals with some health insurers and
pharmacy benefit managers (PBMs) -- firms that negotiate drug prices for
companies and health plans -- that will allow patients to obtain branded
Lipitor at similar or even lower co-payments than those assigned for Lipitor
generics. The arrangements also mean health insurers working with Pfizer
will pay no more for branded Lipitor than for the generics."
The AT&T Vice President of Benefits replied: “I started to respond in writing
here, but I don’t think that’s the best strategy. The issue is just too complex
to describe in writing. So I’m going to ask you to contact one of my
managers who has responsibility for Pharmacy at AT&T, and she is best
positioned to go through this and answer your questions."
The Human Resources representative informed the AASBCR® Benefit
Director. "CVS Caremark does not set the prices. The pharmaceutical
manufacturer, in this case Pfizer sets prices. Pfizer has done some unusual
things to try to keep their market share. They are offering coupons and
rebates to artificially keep the price of Lipitor lower than that of the generic
Atorvastatin. AT&T is passing the rebates that Pfizer is offering 100% to the
participants of the AT&T plans. If AT&T pulled the Pfizer/Lipitor rebate now
being passed to the participants and AT&T kept it instead, we would not be
having this discussion. The Lipitor price would definitely be higher than that
of the generic, Atorvastatin.
The contract between AT&T and CVS Caremark is programmed on the entire plan, not only on one drug. 99% of generics are lower in price, Lipitor is an anomaly. Since the generic came on the market on November 30, there should be a price adjustment after the six months when the FDA allows this version of Atorvastatin to be the exclusive generic for Lipitor. When a mail order prescription comes to CVS Caremark, it is first reviewed by a front room pharmacist. He/she looks at the clinical makeup of the prescription, does it work with what else the participant is taking, then checks if it follows the AT&T plan. That plan calls for replacing branded drugs with their generic equivalent. In the case where there is a generic, that pharmacist will reach out to the doctor and attempt to change the branded prescription to generic. That pharmacist does not know the pricing. That pharmacist is administering AT&T's plan." Since you now know that CVS Caremark is not checking pricing, be an informed healthcare consumer. The burden is on you to check the price of any prescription that you have filled. As to Lipitor, if Pfizer offers yet more rebates or coupons, that may keep the Lipitor pricing down even longer. Until the artificially lower price of Lipitor ceases, call or check the CVS Caremark website before ordering. Keep in mind where you are, personally, with your yearly deductible as that affects the cost from CVS Caremark. Remember that, after we meet the yearly deductible, generic drugs cost the retiree less than branded. If the Lipitor is less money for you on your individual plan, ask your doctor to mark your file to not agree to change your Lipitor prescription to Atorvastatin until this situation changes. Also, please be aware that drugs are commodities. Just like milk or beef, the prices change, sometimes daily. Until your prescription is either shipped to you from CVS Caremark or rung up at the CVS retail store, the price can and sometimes does change from the time that you order it. AASBCR® is always working to make the benefit plan that you have work best for you.

Source: http://www.aasbcr.org/bluebulletins/Vol7-No04.pdf