I recently wrote about the generic replacement for Lipitor and the large pricing discrepancy among Part D plans for Atorvastatin.  One Part D plan charges an $8 co-pay for Atorvastatin while most other plans charge $43 or more. The retail value is reported by the insurance companies as between $90 and $100. At Costco, Atorvastatin can be purchased without insurance for $17 for a 30-day supply of the 10 mg dosage.

Now five drug and grocery chains are suing the maker of Lipitor, accusing Pfizer Inc. of delaying sales of the much cheaper generic, Atorvastatin.

Walgreens and Kroger (parent company of Frys) are part of the suit. According to an AP story:

The lawsuit also accuses Pfizer of making deals with companies that manage prescription benefits, giving them big discounts on brand-name Lipitor in exchange for those companies limiting sales of generic versions.

I received an email from a woman who has also been asking questions about getting Atorvastatin instead of Lipitor. Here is what Marian wrote to me:

I am currently enrolled in Cigna Medicare Advantage.  I get my prescriptions filled at a Cigna Clinic.  My last Lipitor prescription was filled for 90 days.  When I got my May Summary from Cigna it says the plan paid $431.75  and I paid $15.00 for my co-pay.  A total of $446.75 that counted against my Part D total for the year.  I am now only allowed $992.66 for the rest of the year.  They filled the prescription with brand name Lipitor, telling me that it would have cost me more if they used the generic .  What is wrong with this?  It’s been 7 months since this drug went generic.  Does Cigna have a deal with Pfizer or what?

A week later, Marian wrote me again with an update:

I found out another piece of the puzzle today.  I took a chance and called the phone number on my Summary that I get from Cigna each month.  I said to the person that answered for Cigna, “ I think I over paid for Lipitor.  Would you please check my account?”

He looked it up on the computer after asking for my ID.  No, he said that price is right.  $541.00 + 15.00.  I asked him why I could go to Costco and get a 90 day supply of generic for $42.00.  After I repeated the question he simply said “We can’t compete with Walmart or Costco because they deal in volume”.

I’m not so sure the answer Marian got from the Cigna rep is correct. It looks like Pfizer has a deal with Cigna so Cigna has continued to provide her with Lipitor rather than the generic.  So Marian is headed into the donut hole because her Part D account is being charged for the expensive brand drug.

I feel bad for Marian, but I am angered at the effect on the Medicare budget – because Medicare pays for the drugs, not Cigna. Is Medicare paying the brand price, which is ten times the generic price? Multiply $400 times 1 million Lipitor prescriptions and you get…. $400 million! And this is just for 90 days! And there are probably more than 1 million people buying Lipitor through their Part D plans.

Is Medicare paying out hundreds of millions of dollars for Lipitor because of the deal Cigna and other insurance companies have made with Pfizer?  That’s a question somebody needs to answer.

This entry was posted on Monday, July 9th, 2012 at 8:21 am and is filed under Health. Tags for this post: arizona part d, atorvastatin cost, cigna medicare advantage, lipitor generic, part d help, part d tucson. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.