Wednesday, October 21, 2009

PBMs Still Looking Out For #1?

Therapeutics Daily reports on physician complaints related to a letter sent by CVS Caremark promoting the use of Cymbalta for fibromyalgia.  Here's what a Cochrane Review said about Cymbalta for fibromyalgia:

"No direct comparison has been performed between duloxetine and any of these other drugs. As yet it is not clear whether the use of duloxetine is cost effective when compared to the other drugs already in use."

It doesn't sound like the letter offers good information on selecting the highest value medication.  So they may not be looking out for plans and patients as #1.  But I also wonder whether the revenues from this letter would be offset by their lost profit margins if utilization moved away from generics and to brand-name drugs.  Both retail and mail-service pharmacies tend to make more money on generics.  Is this a case of shooting everyone in the foot?

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