The move is clearly a reaction to Caremark’s no-tobacco preferred pharmacy network. Express Scripts however has gone further with its concept for a “no sin” network.
Below, I ask whether payers really want pharmacies to be goody two shoes. Instead of writing your thoughts on a pound note, let me know what you think by posting a comment below.
DON’T DRINK, DON’T SMOKE
In Thoughts on Caremark’s No-Tobacco Preferred Pharmacy Network, I review key managed care and pharmacy industry issues associated with Caremark’s proposal. My comments apply to the notional Express Scripts network, too.
The Caremark no-tobacco network has at least one small plan sponsor, with about 5,400 nonunion employees covered by the City of Philadelphia. By contrast, Express Scripts is merely researching the concept, per the WSJ:
“Some clients have inquired about creating networks that include pharmacies that do not sell tobacco or alcohol,” the Express Scripts spokesman tells us. “We regularly survey our retail pharmacy partners on many topics and we are doing so now. At this point, we are gathering information.” He adds that Express Scripts is looking to provide “better clinical outcomes in the most cost-effective way possible.”I'm still skeptical that payers will readily adopt "no sin" networks. A few questions:
- Why should people who don’t smoke or drink pay higher co-pays simply because their pharmacy sells tobacco or alcohol to someone else?
- Unlike tobacco, moderate alcohol consumption has been shown to have some beneficial health effects. What is the health rationale for a co-pay penalty?
- It will be harder to form a no-alcohol network, since the large chains sell alcohol in some states. In 2011, Walgreens even launched Big Flats 1901, its own private label beer. See Walgreens Rx for Growth: Beer! (Stephen Colbert has a great analysis of Big Flats. Start watching this video at 2:13.)
WHAT DO YOU DO?
Regular readers probably already guessed that this video would make an appearance today. No subtle innuendos here on Drug Channels!
