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UnitedHealthcare Disrupts Insulin Users So Either Change or Pay More–No Generics Here, Just a Bidding War For A Contract

Posted Dec 06 2010 8:16pm

NovoLog users can avoid a price spike by switching to another insulin, Humalog per United Healthcare and this is all a shake up of a bidding/contract situation, so who ever comes in at the lower bid moves to the cheap spot at tier 1 and the other ends up at the top level at tier 3, but no tier 2 in the middle. image

Now just wait until they get some of their subsidiaries involved in more action, and again I say this time after time pay attention as subsidiaries put money to the bottom line.  We have this subsidiary about 3 petals down the daisy chain here in China working to get more Chinese drugs and devices into the US and globally so will one of their products make the tier one some day?  Better think about is as that is how they do business with contracts and the company already has an open line of communication with the FDA.

From the website: image

“We are familiar with the Chinese regulatory system and are well connected with most of the top urban class A  hospitals and clinical trial centers that are GCP certified by the China State Food and Drug Administration (SFDA). Moreover, since we worked many years in multi-national pharmaceutical companies ,we are well versed in ICH, European and United States Food and Drug Administration (FDA) requirements on Good Clinical Practice (GCP).

It all about those cost algorithms once again.  Next time you see a press release watch for the following descriptive words, “ robust formulary program”, I crack up every time I see that template used in press releases but I guess they need to be robust to handle the ever changing data. 

"This isn't about medicine," said Dr. Anne Peters, director of USC 's Clinical Diabetes Program. "It's about finance."

How does this effect keeping diabetics healthy and stable?  Even United itself says it can be disruptive to the patients, but catch the bottom line here is that they don’t care as it’s all about price. 

You have to ask yourself, what’s going to be the catch on the next contract and will this require once more another shift?  You can also see what their algorithms created in Arizona where Keith Olbermann states in his coverage it was the formulas used by Arizona from United Healthcare (and we can probably all guess that was Ingenix, their data folks that do all of this work) at the bottom of it.  In Arizona, people without medical backgrounds made their decisions and look what the inability to decipher and use data ethically created.  This is a big problem and they don’t care and the shareholders don’t seem to mind what compensation is paid and it’s all out expenditures on lobbyist efforts too.  BD

The health insurer is raising the price of NovoLog by 250% while lowering the price of a similar drug, Humalog. The shift will force those on NovoLog to make difficult choices. It also shows how out of whack the healthcare system is.

People with diabetes were notified the other day by insurance giant UnitedHealthcare that one of the most widely prescribed insulins, NovoLog, is switching from the company's Tier 1 drug list to Tier 3.

That means it's moving from the cheapest category of drugs to the most expensive.

Tim Heady, who runs UnitedHealthcare's pharmaceutical operations, insisted the company is acting in patients' best interest by offering at least one insulin in Tier 1. To do this, he said UnitedHealthcare creates "a competitive situation" among drug companies.

In other words, the company engineers a bidding war. The company that bids lowest gets to be in Tier 1. The losing bidder moves all the way to Tier 3.

UnitedHealthcare's Heady declined to discuss details of how different drugs end up in different pricing tiers. But he acknowledged that changes every few years can be disruptive to patients.

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