This article is more than 5 years old. Information may no longer be current.
BLOG: Philidor’s loss is a loss for patients
Since when are we, physicians, in the business of defending insurance companies? The bane of our collective existence, and by extension that of our staff, is interacting with insurance companies. We fight tooth and nail to get paid for the work we’ve already done and then have to turn around and fight equally hard for insurance companies to pay for the treatments we’ve prescribed for our patients. Now all of a sudden we are supposed to support insurance companies in their quest for profit at the expense of pharmaceutical companies in their identical quest?
Tell me, dear doctor, how that makes any sense.
Valeant has been eviscerated for using a “captive” pharmacy company to increase the fulfillment of prescriptions written for its branded medications. The pharmacy, Philidor, accomplished this on behalf of our patients by subjecting insurance companies to a healthy dose of their own medicine. In a word, Philidor was as persistent and imaginative in its pursuit of payment for medications as the insurance companies have been in their quest to avoid such payment. Admit it, you know exactly what I’m talking about when it comes to every single health insurance company.
In this “battle” between equally unappealing combatants, how can any doctor side with insurance? Seriously, help me out on this one. What value is a large insurance company like Anthem or an equally huge pharmacy benefit manager like CVS adding to the system when it comes to our health that is the equivalent of making effective medicines? Why is it any more objectionable for a pharma CEO to make an obscene salary than the guy running Aetna? Neither one of them deserves to make more than you. You’re gonna pick the group that doesn’t even sorta, kinda help you do your job? Make no mistake, neither side of this battle is really all that concerned about you or your patients; this is a battle for profit.
I’ve made no bones about my feelings about Valeant and its cynical business model, but Bausch + Lomb makes stuff we all want to use. As a dry eye guy, I prescribe gallons of Lotemax Gel, and I’m bone weary of fighting to have it “covered” on behalf of my patients. As I write this, Valeant has severed ties with Philidor, making my own personal battle that much more difficult to wage. Watch every other pharmaceutical company cave when it comes to their “captives.” We are now down one very effective strategy to help our patients use branded meds when we prescribe them, and the vocal support of physicians and their trade groups contributed to its demise.
As the old Bolshevik saying goes, you may not have an interest in war, but war may have an interest in you. Choose your sides well.
Disclosure: White reports he is a consultant for Bausch + Lomb, Allergan, Shire and Eyemaginations and on the speakers board for Bausch + Lomb, Allergan and Shire.