Wolters Kluwer Pharma Solutions Release: Managed Care Pushes Back at Lipitor
“At 41 percent market share, Lipitor is ahead of the game, at least compared to Aricept and Cozaar, both blockbuster drugs that lost patent protection in the last two years,” said Rusty Jones, a Wolters Kluwer inThought analyst and author of the report. “Our latest data, however, show that it may be losing more ground than the traditional prescription data suggest, especially on the important battle ground of managed care coverage.”
Pfizer has employed several managed care strategies to maintain its brand share with Lipitor, including aggressive rebating with payers and the use of co-pay cards to reduce patient out-of-pocket costs. Even with the lowered patient costs, according to the report, Pfizer has retained less than half the total atorvastatin pill count ten weeks after the generic became available. Further, recent data show that only 35 percent of approved atorvastatin claims are for brand name Lipitor.
“Since the 35 percent approval volume is lower than Lipitor’s current market share, the claims data suggest that Lipitor volumes will continue to decline,” noted Jones. “Despite the discounts, managed care plans are still financially motivated to put their patients on generic atorvastatin.”
Dynamic Claims data offer a detailed look into the Lipitor market share by compiling pharmacy claims (the financial transactions that transpire between the pharmacy and the managed care plan when a prescription is filled). This allows a view into the tactics that managed care organizations use to control access to branded and generic products. Metrics available through Dynamic Claims include how often Lipitor and other drugs are submitted to a plan, how much a patient must pay to receive the prescription, how often the plan denies payment (rejected claims), and how often a branded product is switched for a generic.
According to the Dynamic Claims data, rejected claims for Lipitor increased immediately after the availability of generic atorvastatin to nearly 8 percent in December. In addition, patient reversals also increased to nearly 10 percent. Reversals are when a patient abandons a prescription at the pharmacy often because the co-payment is deemed too high.
As a result, the report concludes, “a sharp increase in both plan rejection rate and patient reversal rate for top Lipitor payers shows that plans are moving aggressively to migrate patients to generic atorvastatin.”
“Even if Pfizer is successful at forestalling the generic erosion of Lipitor, the question is, ‘is it worth it?,’” said Ben Weintraub, Director of Research, inThought. “Pfizer is well on the way to becoming the lead payer for branded Lipitor, meaning that even if it sells more pills, its profit-per-pill is declining significantly. Matching the number of dispensed prescriptions to the quarterly Lipitor revenues reported by Pfizer will quantify this issue, but these early data suggest that Pfizer’s best efforts, sure to be expensive, may not lead to better performance than those of other branded blockbusters that have recently lost patent protection.”
Led by a team of industry veterans with extensive investment research experience, inThought delivers actionable market research reports read by pharmaceutical and healthcare professionals worldwide. This report and subsequent monthly updates to it are available to all inThought subscribers. For more information visit the inThought website at www.in-thought.com. For additional information, visit the Wolters Kluwer Pharma Solutions homepage at www.wolterskluwerpharma.com.
About Wolters Kluwer Pharma Solutions
Wolters Kluwer Pharma Solutions, Inc. (Phoenix, AZ) is a leading provider of information and analytics to the pharmaceutical, biotech and financial industries. The company’s brands include Source®, ProMetis™ and inThought™. A longstanding provider of market data and healthcare analytics, Source offers a unique set of comprehensive patient and physician-level prescribing and usage data. ProMetis provides a three-dimensional market view of prescriber, patient and payer activity in a breakthrough, integrated platform. Led by a team of industry veterans with extensive sell-side research experience, inThought delivers actionable market research reports read by pharmaceutical and healthcare professionals worldwide. For more information, visit www.wolterskluwerpharma.com and www.in-thought.com.
Wolters Kluwer Pharma Solutions is a part of Wolters Kluwer, a market-leading global information services company with 2010 annual revenues of €3.6 billion ($4.7 billion).
Thomas M. Kivett
Managing Director
Kivett & Company Communications, LLC
332 West 19th Street, Suite 2A
New York, NY 10011
phone: (212) 727-2935
fax: (212) 727-2552
email: tkivett@kivettandco.com
www.kivettandco.com