Y ED SILVERMAN
Star-Ledger Staff

It's not unusual for a major corporation to push employees to use more
generic drugs to help lower health-care costs.

Unless the company is a big drug maker.

In a memo to employees last month, Novartis Pharmaceuticals urged
workers to choose more generics and over-the-counter medications, and
also purchase more medicines through mail order to "control the
escalation of costs."

"Every major company in the U.S. has felt these increases (in health
care) and, as a result, many corporations are reducing or restricting
their benefits coverage for employees," wrote Paulo Costa, chief
executive of the East Hanover-based company. A copy of the Sept. 21 memo
was obtained by The Star-Ledger.

The effort by Novartis comes at a delicate time for the pharmaceutical
industry, which is under attack for the rising cost of prescription
medicines. Drug makers maintain that current pricing is needed to
support the expense of researching and developing new drugs.

But critics said the cost-cutting move by Novartis undermines the
industry's position. As they see it, the company is conceding that
prescription-drug costs are rising so rapidly that even a large drug
maker can't afford to cover costs for its own employees.

"This is very hypocritical," said Jerry Flanagan, health-care policy
director for the Foundation for Taxpayers & Citizens, a nonprofit group
that earlier this week chartered a train that took seniors from along
the East Coast to Canada to buy drugs. "This is a well-deserved dose of
their own medicine."

Said Alan Sager, the director of the Health Reform Program at Boston
University: "They've become a victim of their own success. And it
appears that when the bottom line is involved, a drug maker can be as
rational as anyone else."

Others pointed to the irony of a brand-name drug maker encouraging its
employees to use generic drugs. For several years, many drug makers have
fought lengthy court battles to prevent lower-cost generic medicines
from reaching pharmacy shelves.

However, Novartis spokesman Bob Laverty noted that the company owns
Sandoz, a generic drug maker. He added that "encouraging our employees
to be more aware of rising health-care costs and ways they can play a
bigger role in helping to control these costs is smart."

The Novartis memo said that employee use of generics and other
cost-saving options is "significantly below the norm."

Nonetheless, one industry supporter said the move sends the wrong
signal. In his view, Novartis is failing to bolster a long-standing
industry position that brand-name drugs represent the best science and,
therefore, sound medicine.

"They're not upholding their credo," said Robert Goldberg, director of
the Center for Medical Progress at The Manhattan Institute, a
libertarian think tank. "They've got to show they really believe in the
science of the drugs they develop."

There's little debate that prices for many prescription drugs are
rising. A survey by FamiliesUSA, a consumer-advocacy group, found that
prices, on average, for the 30 medicines most frequently dispensed to
seniors rose 4.3 times faster than inflation last year.

Boston University's Sager pointed out that spending on prescription
drugs doubled recently to $250 billion, from $125 billion in 1999. This
includes expenditures by insurers, hospitals, nursing homes and
uninsured individuals.

In response, seniors are flocking to Canada and the Internet in search
of better deals. Legislation is pending in Congress to permit so-called
reimportation of drugs from Canada. Several cities and states,
meanwhile, are creating reimportation programs.

It's not clear how much Novartis hopes to save by promoting the use of
generics by employees. The memo noted more than $100 million is spent on
annual benefits. Novartis and Sandoz drugs -- their brands include
Lamisil, Ritalin and Diovan -- will remain free to employees, and
co-pays and deductibles won't change.

"It could be a smart move," said Steve Findlay, a health-care analyst at
Consumers Union. "They could save millions of dollars. I'd like to see
the calculations."

Among other big drug makers, a Merck spokesman said employees are
encouraged to seek lower-cost generics. A Pfizer spokesman said the
company plan doesn't differentiate between brand-name and generic drugs.
Spokespeople for Wyeth, Schering-Plough, Johnson & Johnson and
GlaxoSmithKline said employees are free to choose.


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