Connecticut comptroller tackles Horizon’s
combo generic drugs

Pharmaceutical company Horizon is facing a new legal threat from the Connecticut state authorities. Comptroller Kevin Lembo – who overseas the health plans for state employees – has taken action against two of Horizon’s drugs, which involve generics, and is also demanding an investigation into the company’s links with two specialty pharmacies.

The drugs in question are Duexis and Vimovo, both of which have previously been the source of controversy. Duexis is a combination of ibuprofen and the generic drug Pepci, while Vimovo is formed from an ingredient of Nexium and naproxen.

In both 2015 and 2016, the drugs were excluded from the formularies of leading pharmacy benefits concern Express Scripts, on the grounds that they were expensive substitutes for widely-available, generic drugs, but Horizon has since persuaded Express Scripts to take up the drugs. Lembo’s argument is essentially that nothing has changed, and that the components for the Horizon drugs are cheaply and widely available elsewhere.

The comptroller has announced a ‘prior authorization’ regulation covering both of the drugs, under which prescriptions will only be covered by the state plan once authorized by a physician, who is able to confirm that their use is medically necessary.

Horizon has previously stated that its single-pill combinations are not just a matter of convenience for patients, but that there are no clinical equivalent generics alternatives, rejecting the contention that they are merely repackaged generics, or that there are any generic pharma law implications.

Lembo has also taken aim at the links between two specialty pharmacies and Horizon after one health plan showed that for two pharmacies in the state, Horizon products made up the vast majority of its prescriptions. Previously, there have been investigations by federal agencies in cases where wrongdoing has been alleged, particularly around the problem of drug companies allegedly using such pharmacies to promote expensive products when cheaper generics alternatives exist.

According to reporting by FiercePharma, the comptroller is calling for a state investigation to establish the precise nature of the relationship between the pharmacies and Horizon: “This review is necessary to ensure that prescription and medical care decisions are motivated, first and foremost, by what’s best for the health of patients – and not motivated by the financial interests of drug corporations.”

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