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Health Care Advocates' Pricing Pushback

03/23/06 - 07:04 AM EST

Melissa Davis

Guidant has already won a favorable ruling in that case and is now seeking an injunction against Aspen Healthcare Metrics, a division of the purchasing organization, so it can keep its pricing information from spreading. Guidant has gone so far as to argue that such a ruling would help the public interest.

"Tortious interference with contracts between a medical device manufacturer and the hospitals that use its devices is not in the public interest," Guidant states in a recent courtroom filing. "Aspen's intent with respect to obtaining and using Guidant's confidential information is not to benefit the public. Aspen's sole motivation is to profit from that information."

'Unequal Fight'

Pharmacy benefit managers have offered somewhat similar arguments when defending their own secrecy. They portray their financial arrangements with drug manufacturers as proprietary and claim that enhanced disclosures would hurt -- rather than help -- the public interest.

So far, PBMs have managed to convince a number of states to take their side. Earlier this week, the industry's powerful lobbying group -- known as the Pharmaceutical Care Management Association -- boasted that six states have now rejected new PBM disclosure laws so far this year. PCMA said that it "believes strongly that the bills went down to defeat in large part because they would have increased prescription drug costs for consumers and employers."

Merrill Lynch analyst Thomas Gallucci quickly publicized PCMA's claims, saying that the "PBM business model [is] proving its worth" and recommending two major PBM stocks -- Caremark (CMX - Cramer's Take - Stockpickr) and Medco (MHS - Cramer's Take - Stockpickr) -- as a result. Merrill Lynch owns at least 1% of Caremark's stock and expects to receive investment-banking business from Medco over the next three months.


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