A Growing Confrontation — Between Merck/MSD and British Purchaser/Payor Organizations

Here’s a story that highlights the tug-of-war over what — it is thought — would be an appropriate discount scheme, in a unified payor system. The import of this is clear — margins are evaporating in the United Kingdom, especially on mature legacy Schering-Plough brands like Nasonex, Neoclarityn and Nuvaring.

Here is just a bit of the full Dispensing Doctors’ Association news item, for the United Kingdom — do go read it all:

. . . .If you order the above products through Alliance there will be no manufacturer discount in addition to its current 7.5% commercial terms. However, all MSD products are excluded from Alliance Healthcare’s surcharges.

PSNC has said the scheme reduces competition. Dr Richard West, DDA chairman said: “MSD’s RWM shows that the current model of reinbursement minus clawback is no longer viable if the large pharmaceutical firms do not put 11.18% discount in to the system.” He also asked: “Why do the large pharmaceutical firms choose not to understand the UK market place?”

An AAH spokesperson told DDA Online: “We are disappointed by this decision as we continue to believe that including AAH as a distribution partner is in the best interests of MSD, patients, customers and the wider NHS.”

However, in support of the new arrangements, MSD says they will ensure that dispensing doctors who would like access to the Manufacturer Discount Scheme can get these via Phoenix and Williams. . . .

We will — of course — keep you posted.


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