December 2011  |  Volume 2, Number 12

Pfizer Strikes Pharmacy Deals to Hold Lipitor Sales
  • Pfizer Inc. is seeking to add Express Scripts Inc. to the list of U.S. pharmacy benefit managers that won't dispense generic Lipitor after it loses patent protection this month.
  • Deals with insurance companies may help Pfizer retain as much as 40 percent of users through May.
  • Under Pfizer's agreements, the companies will block generic versions of Lipitor from reaching some customers until the end of May 2012.
  • A Pfizer spokesman said the agreements wouldn't raise costs for insurers who make the deals.
  • Watson Pharmaceuticals Inc. has an agreement with Pfizer for an "authorized generic" version of Lipitor that will hit the market on Nov. 30, and will split revenue with Pfizer on the pill.
  • If India's Ranbaxy Laboratories Ltd. resolves a dispute over its manufacturing plant with the U.S. Food and Drug Administration and the Justice Department, it has the rights to bring its own generic competitor to market on that same day.    


For the full Businessweek article, click here.

Contracts, Compliance and Research Updates
Legal Questions and Answers That Will Decide the Health Law's Fate

The challenge to the Affordable Care Act that the U.S. Supreme Court will consider this March involves a series of complex and interrelated questions. How the court views each one ---- including the constitutionality of the law's individual mandate and Medicaid expansion, as well as the application of the Anti-Injunction Act and the question of severability ---- will trigger a cascade of related decisions. What the court finds will determine whether the measure is implemented in whole, in part or at all.


With Stuart Taylor as a guide, Kaiser Health News provides a diagram to help explain how the sweeping health law's implementation could proceed ---- or not ---- based on each of these questions.


Although the Anti-Injunction Act does not apply to the constitutionality of the Medicaid expansion, the diagram is designed to show how the various decisions related to each could potentially interact.


Click here to view the full diagram.

Read Stuart Taylor's analysis here.


FAQs About Affordable Care Act Implementation (Part VII) and Mental Health Parity Implementation 

The Departments of Health and Human Services, Labor and the Treasury have prepared Frequently Asked Questions regarding implementation of the Affordable Care Act as well as the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). These FAQs answer questions from stakeholders to help people understand the new laws and benefit from them.



The complete FAQs and responses is available here.

In This Issue
Pfizer Strikes Pharmacy Deals
Contracts, Compliance and Research Updates
Wisconsin Updates


More information regarding Health Care Reform and other benefit resources is available on the HR360 website, available to BSG clients under the "Resources" menu of their HR Express website. HR360 includes new features such as step-by-step interactive guides which make the processes of hiring, termination, COBRA and FMLA so much easier. In addition, there are new online tools such as job description builder and salary benchmarking tool.

BSG subscribes to this service for your benefit. If you would like more information regarding this resource please contact your account management team at BSG. 
Wisconsin Updates

Changes in State Health Plan Design Save Taxpayers $155 Million

Taxpayers will save approximately $155 million next year due to changes in the benefit design for health plans offered to state employees. The majority, approximately $90 million, will be realized as state employees pay a greater share of the premium costs; however, taxpayers will save an additional $65 million due to a new requirement that the state employees pay 10 percent of their medical costs up to an out-of-pocket maximum of $500 for individuals and $1,000 for families.


Dave Jensen, editorial director of HCTrends, notes, "While most of the public debate over Act 10 focused on collective bargaining and health plan contributions, the budget-repair legislation also mandated that the benefit design be changed to achieve a 5-percent reduction in premium costs based on actuarial analysis."


The plan design reduced 2012 premiums for the 26 health plans offered to state employees by an average of 2 percent. 



2012 Renewals Lower than Last Year, but Market Shows Turbulence

Despite a lower increase in health plan costs for next year, the 2012 Greater Milwaukee Health Care Benefits Renewal Survey conducted by HCTrends shows a lot of uncertainty in the market.


Employers expect their health plan costs to increase an average of 5 to 7 percent next year. 41 percent of respondents said they were changing health plans or networks, and 11 percent said they were terminating their health plans. Additionally, 22 percent of employers say they are "likely" or "very likely" to terminate coverage if a state health insurance exchange becomes available in 2014.


Visit to read the full press release blurbs and view results of the 2012 Health Plan Renewal Survey.  

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