Dr. Steve Miller, the chief medical officer of Express Scripts, recently discussed a variety of specialty pharmacy trends, such as the loss of social contract within drug pricing, with Evidence-Based Diabetes Management.
Sovaldi, which is a new drug class for treating cholesterol, recently launched onto the market. This has forced pharmacy benefit managers to make adjustments to their controlling prices strategies for new, breakthrough therapies.
“Drug companies and Wall Street analysts clearly believe that if you have a unique therapy and if you have the patent, then you have almost unlimited pricing power,” Miller said.
There used to be a social contract between investors, pharmaceutical companies and the general public. The purpose was to keep drug costs affordable for the patients who would need the treatments.
Unfortunately, this contract now seems broken, allowing companies to increase drugs to prices that are not related to the cost of manufacturing and marketing the drugs.
Now major employers, health plans and consumers face a variety of new challenges with this changed environment in the industry.
“Thank goodness this line of thinking wasn’t used with the polio vaccine in the 1950s and 60s, or nobody would have been able to afford it,” Miller said.
Express Scripts began in 1986 in St. Louis, Missouri, as a result of a joint venture between a retail chain of more than 79 pharmacies (Medicare Glaser Inc.) and Sanus Corp. Health Systems.