Access to Horizon Pharma Drugs Cut By Two Leading PBMs

Two drugs sold by Horizon Pharmaceuticals (HZNP) are being kicked off the formularies maintained by Express Scripts (ESRX) and CVS Caremark (CVS) starting next year, Horizon disclosed Monday in a regulatory filing. Horizon shares are down 30% to $9.66 in recent trading.

Express Scripts and CVS Caremark are the largest and second-largest pharmacy benefits managers in the U.S. Both have been aggressive with efforts to rein in ever-escalating drug prices by refusing reimbursement unless drug companies offer significant discounts. The New York Times published an expansive article on the fight between drug companies and PBMs in June that's worth reading

The Horizon drugs getting kicked off the formularies are Duexis and Vimovo. Both premium-priced products consist of generic, low-cost pain relievers co-formulated with other drugs to reduce side effects. In the first quarter, Duexis and Vimovo accounted for 92% of Horizon's net product sales. The company reports second-quarter financial results on May 9. 

Horizon estimates 20-30% of its Duexis and Vimovo prescriptions could be at risk by being excluded from the Express Scripts and CVS Caremark formularies. Starting next year, customers of both PBMS won't be reimbursed for the drugs and will have to pay full price if they still want them.

Adam Feuerstein writes regularly for TheStreet. In keeping with company editorial policy, he doesn't own or short individual stocks, although he owns stock in TheStreet. He also doesn't invest in hedge funds or other private investment partnerships. Feuerstein appreciates your feedback; click here to send him an email.

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