Money Spent on Vioxx May Be Recoverable

Human resources consulting firm Findley Davies has notified its clients that self-funded employers may be able to recoup some of the money they spent on Vioxx shortly before Merck’s September 30 withdrawal of the popular arthritis medication.

Merck officials sent a letter to pharmacy-benefit managers in mid-October that described the reimbursement option, which uses a formula to compensate PBMs for the unused Vioxx distributed through retail pharmacies in September and mail-order pharmacies during the third quarter of 2004, according to Bruce Davis, a Findley Davies principal. Davis was briefed about the letter by a health-industry source.

In addition, Merck officials advise the pharmacy-benefit managers to pass along the reimbursement to its payers, including self-funded employers, if they select the formula approach, Davis says. The other option, he says, is “business as usual,’’ with the rebates continuing to go to the pharmacy-benefit managers. PBMs must contact Merck with their preference by November 8, Davis says. Self-funded employers should call their pharmacy-benefit managers, he says, to determine which reimbursement option they will pursue, and whether the refunds will be passed along.

Merck spokesman Tony Plohoros confirmed that a letter was sent to pharmacy-benefit managers on October 11, but wouldn’t provide any details, saying it was a private communication. Spokespeople at Express Scripts and Medco said they’d received the letter and were passing the information along to their clients, but wouldn’t comment further.

Merck officials voluntarily withdrew Vioxx, a pain reliever and arthritis medication, after a study found that patients taking the drug for more than 18 months faced a slightly increased risk of heart attack or stroke. The medication, introduced in 1999, ranked 20th in total U.S. sales in 2003, reaching $1.8 billion, according to the Connecticut-based research firm IMS Health.

The Vioxx withdrawal is one of the largest to date involving a prescription product, says Todd Brown, vice chair of the department of pharmacy practice at Northeastern University School of Pharmacy. Historically, pharmacy-benefit managers don’t have a good track record of passing along rebates, Brown says, pointing to a recent spate of lawsuits. Before companies ask for any refunds, Brown suggests they first verify that the money won’t limit their future legal options. “I wouldn’t want to be taking payment if it’s going to somehow affect my ability to file a legitimate legal claim down the road.”

–Charlotte Huff