Out of concern for the individuals that use its branded medicines, Horizon Pharma announced Wednesday that it is re-evaluating its relationship with pharmacy benefit manager Express Scripts.
As originally reported by the Associated Press, the announcement emerged following news that Express Scripts removed Linden Care Pharmacy from its network. Express Scripts said it's cutting ties with the New York-based specialty pharmacy because the store mainly dispensed Horizon prescription drugs and neglected to comply with certain aspects laid out in its pharmacy network agreement.
"We are reviewing and evaluating all similar captive pharmacy arrangements that we know of and will work to identify others," Express Scripts spokesman Brian Henry said. "By captive pharmacies, we mean those pharmacies that derive the vast majority of their prescription volume from one manufacturer and/or one product."
Henry said the Express regularly checks its network and takes action when it observes "pharmacies trying to circumvent solutions, like formulary management, that protect payers and patients from wasteful drug spend."
Horizon alleges Express Scripts is attempting to eliminate small specialty pharmacies out of its network, like Linden Care, that are in competition with its own specialty pharmacy known as Accredo Health Group Inc. Moreover, Horizon denies Linden is a captive pharmacy for them as less than 5 percent of its sales are the result of prescriptions filled by Linden and processed by Express. Horizon also doesn't have any ownership of the pharmacies distributing their branded medicines.
"Our philosophy of ensuring that patients get the medicine their doctors prescribe is threatening Express Scripts' profiteering and exposing what we believe is a lack of care for patients and respect for physicians," Horizon Pharma President and CEO Timothy Walbert said.
In addition to Express Scripts, Horizon is also questioning its partnership with Accredo.
"We currently have an agreement with Accredo to provide one of our important orphan medicines to patients, and contrary to the misperception that Express Scripts wishes to create, Accredo accounts for a larger percentage of our revenue than any other pharmacy," Walbert said. "However, based on current and past business practices by Accredo and Express Scripts, including its recent $60 million fraud settlement with the U.S. Department of Justice, we are re-evaluating this relationship to determine how we can most appropriately and ethically serve our patients, their physicians and our shareholders."
Besides getting rid of a pharmacy that sold medications made by Horizon, Express Scripts is suing the biopharmaceutical company for approximately $140 million, claiming that Horizon breached its pharmaceutical manufacturer rebate agreement with them. Horizon contends the lawsuit pertains to a previously disclosed dispute in which it terminated a contract it held with Express Scripts after Express failed to meet the terms set out in the agreement and the damages Express is seeking involve prescriptions that happened after the contract ended.
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