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rosemountbomber

07/28/22 5:06 AM

#384491 RE: ziploc_1 #384490

Zip, those PAs are the smoking gun. Your post also made me think about a different subject. You said:

“…to save money for themselves by dispensing the generic version, which they pay less for. “

So does that mean that in those exclusivity arrangements that KM has negotiated with some insurers, that V is costing them less than the GV?

I would have to assume so or else what is the benefit to the insurance co? And, if that is the case then it seems that Amarin could if they wanted to undercut the Generics for the entire US market. Now the margin must be rather small and I assume that is why it sounded like KM was only going to arrange the exclusivity deals for approx 50% of the US market. I assume the overheads ( even after all the cuts) are still a bit too high.

Am I understanding the dynamics here correctly?

Pharmacydude

07/28/22 7:24 AM

#384494 RE: ziploc_1 #384490

Zip/NS
HealthNet continues to this day to offer the generic to patients who have a PA for the cardiovascular indication. If the PA was the smoking gun that people think I am sure they would’ve changed their policy, but they have not.

“Insurance companies all know that they are infringing on Amarin's CVD patents when they fill the prescriptions for Vascepa with the generic version, but they do it anyway to save money for themselves by dispensing the generic version, which they pay less for.”

As I stated previously and if I remember correctly the HealthNet defence quoted caselaw that stated clearly that merely making product “A” less expensive and product “B” was not enough to be found guilty of induced infringement. If it was, it would essentially make it illegal for the generics to be less expensive than V. If V was $300 and the generics go to market at $275 then Amarin could argue they are inducing infringement by making gV less expensive, regardless if the indication is known or not.

NS I agree that your perception of the legal argument by Amarin makes logical sense. I also feel that healthNet is inducing infringement by making the generic less expensive to the patient. I for one have learned that logic and legal outcome have absolutely nothing to do with each other. The law is about finding a loophole and getting through it. Case law stating that merely making the product less expensive is not enough to be guilty of inducing infringement is what HealthNet is counting on to continue to give favourable pricing to the drug that costs them the least amount of money. The only difference with the PA is that everybody knows the indication. Should HealthNet not be allowed to offer gV if they know it is for CVD? It’s not HealthNet’s job to enforce the patents. If gV costs them less than V why do they have to charge more for gV just so they don’t induce their client to violate a patent that their client has no idea even exists?
HealthNet does not appear worried about the suite because if they were they would have changed their policies or their pricing or SOMETHING but instead they proceed exactly as before, they offer the least expensive product available at the lower price.

Even in the best case scenario we are looking at a minimum 3-5 years for this case to be resolved. This freedom to use the lowest cost product is far too important to the insurance industry to not fight to the bitter end and win at all costs.