Investigational Merck drug ‘significantly’ reduces cardiovascular death
WHITEHOUSE STATION, N.J. — A drug under development by Merck "significantly" reduced the risk of heart attack, stroke and cardiovascular death in patients, according to clinical trial results announced Tuesday.
Merck announced the release of data from the 26,449-patient "TRA-2P" study of vorapaxar, a drug designed to prevent clotting of the blood. The drug also showed a significant increase in bleeding, including within the skull, known as intracranial hemorrhage, though there was a lower risk of intracranial hemorrhage in patients without a history of stroke.
"In developing vorapaxar, Merck and our scientific collaborators set a very high bar — would the addition of vorapaxar to standard of care provide incremental benefit in preventing clots?" Merck Research Labs president Peter Kim said. "We are pleased that TRA-2P met its primary endpoint, and we look forward to discussing the results with the scientific community."
Results of the trial will be presented at the American College of Cardiology Scientific Sessions next month.
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Walgreens takes its lumps and moves on
Apparently, there’s life after Express Scripts.
Walgreens took its lumps in January after failing to mend its very public rift with pharmacy benefit management giant Express Scripts, reporting a 2.3% drop in sales for the month. But considering that the PBM’s millions of customers represented $5.3 billion in prescription sales for the 7,818-store drug chain in fiscal 2011, it could have been worse.
January was the first month in which Walgreens operated without benefit of a contract to fill prescriptions for Express Scripts’ millions of members, so it marks a litmus test for the nation’s biggest drug store operator as it moves into a post-ESI era. The impact of that loss of business was plain: In spite of a 2.7% increase in sales at the front of its stores for the month, customer traffic in comparable stores — those open more than a year — fell off 0.6%. The impact on Walgreens’ pharmacy business was much more direct, with pharmacy sales down 6% and comparable-store pharmacy sales sliding 7.9%. What’s more, Walgreens pharmacists filled 8.6% fewer prescriptions during January than they did in January 2011, when Express Scripts accounted for 12.4% of the company’s total prescription volume, according to the chain.
Company leaders were braced for the downturn, and had been since making the momentous decision to walk away from Express Scripts’ costly business in mid-2011. That decision was based on the failure by the two sides to come to terms over the level at which ESI reimbursed the chain for filling its members’ scripts, and since then neither side has budged.
“We expected that January would be a very challenging month on a comparable-prescription basis because of the impacts from not being part of the Express Scripts network as of Jan. 1 and the much milder cough, cold and flu season we have been experiencing,” said Kermit Crawford, Walgreens president of pharmacy, health and wellness services and solutions.
Nevertheless, Crawford said he and other company brass already are well along on the post-ESI strategy that, if successful, could serve as a template for how the retail pharmacy industry’s biggest and most powerful players could reduce their dependence on PBM contracts and still thrive. “With January now behind us, we are moving forward with relationships with large and small employers, health systems, physician groups and other PBMs who value Walgreens’ ability to help lower overall healthcare costs,” Crawford said. “As we expect these relationships to grow, and as we move past the impact from this year’s weak flu season, we anticipate an improvement in the coming months in the number of comparable prescriptions filled relative to January’s result.”
On Thursday, Walgreens added another plank to its new strategic platform when it agreed to buy key assets from BioScrip, a national provider of specialty pharmacy and home health services. The addition of BioScrip’s “clinically focused community specialty pharmacies and access to additional limited distribution drug therapies” will “create a strong network of support for our core drug store business to provide specialty pharmacy solutions to our patients,” Walgreens president and CEO Greg Wasson said. “This acquisition also significantly expands our nationwide reach to an additional half-million patients with chronic and complex health conditions who have strong clinical relationships with their current BioScrip pharmacy,” he added.
Walgreens Leads the Way! period.
NACDS lays down gauntlet against PBM lobby at Regional Chain Conference
NAPLES, Fla. — In the five years since he has led the National Association of Chain Drug Stores, president and CEO Steve Anderson has operated under a sound policy; so simple, it is the advice he gives his own children: “We don’t start any fights — but we sure are going to finish them.” On Monday, Anderson and NACDS chairman Bob Loeffler, who also serves as H-E-B chief administrative officer, told NACDS Regional Chain Conference attendees here, that now they are going to take that fight to the PBM lobby.
NACDS used the meeting to introduce the PBM threat as a new, third pillar to the critical policy issues it currently faces along with Medicaid AMP rule legislation and MTM reimbursement.
“Increased rancor on the part of the PBMs is accompanied by a damaging array of PBM practices, all of which you personally know too well,” Loeffler noted. “Let me throw out just a few and see if they sound familiar to you: lack of transparency; the frequency or should I say infrequency of updating MAC [maximum allowable cost] pricing; more margin compression each year; restricted networks; unreasonable and capricious audit rules; use of our patients’ data; blatant conflicts of interest including converting your patients to mandatory mail order; in short, topics that threaten the sustainability of many in this room, and that threaten the access and cost of care to the patients we serve.”
Anderson and Loeffler drew Regional Chain Conference attendees’ attention a recent series of ads funded by the Pharmaceutical Care Management Association that ask readers to choose between denying a fictitious child named “Maggie’s medications,” or cutting “pharmacy overpayments,” another fiction. “Raise your hands if you’ve ever had any pharmacy overpayments,” Loeffler said. In addition, to running its own ads that tell the industry’s simple story, “Pharmacies. The face of neighborhood health care,” Anderson and Loeffler also urged attendees to participate in its Rx Impact Day meetings next month.
“If you can envision the possibility of your company being pushed off the edge of a cliff, as a result of policies that aren’t right and that jeopardize patient care, then you need to be with us in Washington, D.C., on March 21 and 22,” said NACDS chairman of the board Bob Loeffler of H-E-B. Loeffler referred to NACDS RxImpact Day on Capitol Hill, which will be held in Washington, D.C., on those dates.
Anderson promised to tell the story of community pharmacy as a “disruptive innovator,” borrowing the concept first advanced by Harvard Business professor and author Clayton Christensen, which also inspired the work of the late Steve Jobs at Apple, he said. Pharmacy is providing innovations that are creating new methods of healthcare delivery and that are lowering healthcare costs, he explained.
“If we position community pharmacy effectively as the face of neighborhood health care, this industry will emerge as a disruptive innovator and will create a positive long-term impact on healthcare delivery and for the good of patients. But we cannot just sit back and let that happen; we have to get out and fight for it,” Anderson said.
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