The hypocrisy of Express Scripts

  • Express Scripts said “despite promises to limit price increases, drugmakers are trying to game the market by delaying generic competition, blocking access to safe and effective biosimilars, and coyly deferring – not cancelling – list-price increases. This is why our work to expand access and maximize value is more important now than ever”.
  • In 2015, Express Scripts, the largest PBM-only company in the U.S., reported a profit of more than $660 million, from sales exceeding $25 billion.
  • In 2017, pharmacy benefits giant Express Scripts saw its net income skyrocket by 33% year-over-year to $4.51 billion.

Express Scripts have removed a number of prescription drugs from their formulary thus limiting patient and doctor choices.   They are doing so under the “guise” of lowering overall costs, but although there is some truth to, the drug makers delaying generic competition, it’s all about THEIR profits.

In 2017, pharmacy benefits giant Express Scripts saw its net income skyrocket by 33% year-over-year to $4.51 billion and although a large part of that was due to tax cuts they still managed to institute a large stock repurchase.

While PBMs market themselves as being well-positioned to bring savings to plans and consumers, a lack of transparency in their practices enables them to wield their power to increase their profits, often at the expense of the consumer.

Enough blame to go around

Drugmakers file hundreds of patent applications – the vast majority of which are granted to extend their monopolies far beyond the twenty years of protection intended under U.S. patent law.  There are 38 years of attempted patent protection, blocking generic competition sought by drugmakers for each of these top grossing drugs – or nearly double the twenty year monopoly intended under U.S. patent law.

[pullquote]Over half of the top twelve drugs in America have more than 100 attempted
patents per drug.[/pullquote]

  • AbbVie, which markets the world’s number one selling drug, Humira ($18bn in global sales in 2017), is also the worst patent offender with 247 patent applications.
  • Herceptin, a cancer drug sold by Roche / Genentech, had patents first filed in 1985 and has current patent applications pending that could extend patent exclusivity until 2033, a 48-year potential monopoly span.

One third of the drugs had price hikes of more than 100% since just 2012: Lyrica (163%), Enbrel (155%), Humira (144%), and Lantus (114%).

Yes, the drug industry has “gamed” the system to keep prices high, but Express Scripts are also playing the game for the benefit of their shareholders.  Dropping medications under the guise of helping patients is a joke.  It’s about Wall Street, as always.