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Is a Pill Just a Pill?

According to Express Scripts, a pill is just a pill. Here’s what happened. Walgreens increased its requested compensation from Express Scripts since it offers patients medication management services along with filling their prescriptions. For Express Scripts, this was a non-starter; the price increase was roundly rejected. Express Scripts just wants to pay for medications with no fees. 

Walgreens’ comeback? “Our product is not a pill; our product is a health outcome,” according to Walgreens Chief Executive Greg Wasson. Walgreens continues to push for a higher level of reimbursement, citing their pharmaceutical care or value added benefit of pharmacist consultation, patient teaching, and other services that improve outcomes.  

At BioPlus, we certainly know about “health outcomes.” By setting up high-touch patient programs, we achieve the highest compliance rates in the industry, which gives our patients the best chances for healthy treatment outcomes.  

We don’t just make this claim; we back it up with real data. A sampling of treatment programs at BioPlus, which included more than 22,200 BioPlus patients being treated for hepatitis C, oncology, rheumatoid arthritis, psoriasis, Crohn’s disease, and other conditions, showed that BioPlus achieves a 91 percent compliance rate at discharge. By comparison, the compliance rate for retail and mail-order pharmacies is only 50 percent. 

Since healthy outcomes rank as such a high priority with us, it probably won’t be surprising to learn that BioPlus is opposed to the merger of Express Scripts and Medco. Once joined, the outcome for patients would not be so healthy; there could be reduced access, increased prices, and diminished care for thousands of vulnerable patients. Remember these are two of the three largest pharmacy benefit managers (PBM) and specialty pharmacies in the United States. If the merger is approved, Express Scripts would garner 52 percent of the specialty pharmacy business.  

Express Scripts made it very clear in those recent dealings with Walgreens that it sees absolutely no value in patients receiving clinical pharmacy services. Yet post-merger (if it were to go through), Express Scripts could limit specialty pharmacy network access and pressure manufacturers into exclusive distribution arrangements, resulting in higher prices for consumers and less patient choice. 

Specialty pharmacies, by definition, supply specialty medications to patients being treated for complex, chronic conditions such as hepatitis, hemophilia and other bleeding disorders, multiple sclerosis, Crohn’s disease, and certain forms of cancer. These vulnerable patients cannot and should not be expected to just receive a bottle of pills and be good to go – which would be Express Scripts’ likely plan.

BioPlus follows a much different plan than Express Scripts. We create an individualized care plan for every patient and then monitor the patient and the care plan throughout the entire treatment process. We provide ongoing patient education, refill reminders, work with patients about what to expect in terms of side effects and how to work through the side effects, and offer 24/7 access to a Doctor of Pharmacy. This is how we’ve treated patients for the past 22 years and we don’t plan to change, no matter what happens with Express Scripts.

Stephen C Vogt, PharmD
President and CEO
BioPlus SP


Source: Martin, TW. Walgreen Prescribes Rate Change. Wall Street Journal. October 25, 2001. B1.


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October 2011
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