News & Commentary

Former Pharma Sales Reps Enlisted To Fight Drug Costs

Capital District Physicians’ Health Plan (CDPHP), an Albany, N.Y., insurer, went over to the dark side and did some recruiting. The insurer hired former pharmaceutical salespeople to help it alert doctors about the price of some medications and how to adjust prescribing habits so that patients don’t get hit with exorbitant copayments, Kaiser Health News reports.

Take Mike Courtney, for instance. He’s a former salesman for Pfizer and Johnson & Johnson. Now, instead of visiting physicians to tout the latest, greatest, and most expensive, Courtney will tell them about cheaper alternatives.

Physician prescribing guides do not often contain specific information about drug costs. “Drug sales reps who visit their [doctor] offices don’t highlight high prices as they drop off free samples, and drug­makers can quietly but substantially hike the price of a drug from one year to the next,” Kaiser reports.

Two years ago, Valeant Pharmaceuticals raised the price of a dose of Glumetza, a drug used to lower blood sugar, to more than $80,000 a year, 20 times what it had been a few years earlier. Meanwhile, a generic version can be purchased for as little as a penny a pill.

This put CDPHP in a difficult position because Glumetza is on its formulary. Member copayments had to offset the exorbitant cost. Courtney and five other former pharma and medical device sales representatives fanned out and let the doctors know how they can save patients money.

The result was that all but a handful of the 60 plan members who had been taking Glumetza switched to the generic, metformin, saving CDPHP about $5 million a year.

Eric Schnakenberg, MD, an upstate New York family medicine doctor, appreciated the effort. “As physicians, we’re blindsided” by drug companies quietly raising the prices year by year, he told Kaiser. “We get patient complaints saying, ‘Hey, I can’t afford this,’ and we say: ‘It’s cheap!’”

“When the products go generic, nobody’s promoting them anymore,” said Courtney, the former sales rep.

A blueprint for high-volume, high-quality lung cancer screening that is detecting cancer earlier—and helping to save lives

Clinical Brief

Multiple Sclerosis: New Perspectives on the Patient Journey–2019 Update
Summary of an Actuarial Analysis and Report