Express Scripts, CVS Cut Ties With Valeant Partner Philidor

The three largest pharmacy-benefit managers said they’re moving to terminate Philidor RX Services, the mail-order pharmacy that’s a partner of drugmaker Valeant Pharmaceuticals International Inc., from their networks.

Express Scripts Holding Co., the nation’s largest manager of prescription drug benefits, said in a statement that it’s “in the process of terminating the Philidor pharmacy from our network.” It’s also evaluating four other pharmacies that Valeant has a similar relationship with.

The company also said it was reviewing and evaluating “all similar captive pharmacy arrangements,” referring to pharmacies that derive the vast majority of their prescription volume from one manufacturer or one product.

The second-largest drug benefits manager, CVS Health Corp., also said in an e-mailed statement that it would remove Philidor from its network of pharmacies after an audit of its practices.

“CVS/caremark maintains a broad national network of 68,000 pharmacies. In accordance with CVS/caremark’s standard auditing protocols, over the last several weeks we have been monitoring and reviewing the results of recent audits of Philidor’s practices. Based on the findings from those activities, we have terminated Philidor for noncompliance with the terms of its provider agreement,” CVS said in an e-mailed statement.

OptumRx Audit

OptumRx, UnitedHealth Group Inc.’s pharmacy-benefits business, “conducted an audit of Philidor in late 2014 and subsequently began terminating them from all networks in the interests of our customers,” according to Matt Stearns, an Optum spokesman. Optum is the third-largest drug manager in the U.S.

Valeant, in a statement, said it sells its drugs through a variety of channels.

“We look forward to continuing to work with our full range of partners to ensure patients have access to the important medicines they need,” the company said in an e-mail.

Some Blue Cross and Blue Shield health insurers also are looking into Valeant’s specialty pharmacies, according to a person familiar with the matter, who asked not to be identified because the process is still under way.

Philidor declined to comment.

Anthem’s Evaluation

Anthem Inc., which has about 38.7 million health-insurance customers, uses Express Scripts to handle its pharmacy benefits, but sometimes makes its own decisions on drug coverage. The company, which operates some Blue Cross and Blue Shield plans, said in a statement that it’s “working collaboratively” with Express Scripts as the pharmacy-benefits manager evaluates Valeant’s use of affiliated pharmacies.

“Anthem Inc. contracts with Express Scripts to provide access to pharmacy networks,” the health insurer said in an e-mail. “Anthem will continually monitor any developments that could impact members in this area and work collaboratively with ESI to take appropriate action.”