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MARION MERRELL DOW CARDIZEM CARD PROGRAM COULD CUT PATIENT COST BY 15%

Executive Summary

MARION MERRELL DOW CARDIZEM CARD PROGRAM COULD CUT PATIENT COST BY 15% per year, based on a calculation of the program's free-prescription bonuses and the average daily dose of the standard-release calcium channel blocker. The program, recently unveiled by Marion Merrell Dow, is keyed to the enrollment of patients in a card-carrying "Cardizem Medication Plus Program." Patients will carry special Cardizem credit cards that will permit them to receive free prescriptions after they have reached certain Cardizem usage levels. The program is initiated by the prescribing physician who gives the patient an enrollment package containing information and a voucher for a free introductory 21-tablet supply of 60, 90 or 120 mg Cardizem. For filling the introductory prescription, the pharmacist receives AWP reimbursement from Marion Merrell Dow plus a $4.50 fee. The card program is being administered for Marion by PAID Prescription, Inc. The program appears to be a patient cost-cutting response by Marion to the aggressive programs undertaken by Searle (Calan SR) and Pfizer (Procardia XL). The Marion discount club approach is physician-driven compared to the broad advertising tack being used by Pfizer or the promotional giveaway that Searle undertook in 1988. The discount levels derive from free refills offered to Cardizem patients. Card-carrying members get 90 free tablets of the chronic use medication after cumulative purchases of 540 tablets. For each 90-tablet supply purchased, a patient receives one point. After accumulating six points, a patient receives a coupon redeemable for a free 90 tablets. The Cardizem credit card is used by pharmacists to keep track of prescribed units. The standard-release Cardizem dosage form is taken three-to-four times daily in an average regimen. The 90-tablet increments are thus equivalent to approximately a three-to-four week supply of the drug. Patients on a maintenance dosage would get about eight or nine weeks of the drug free of charge during a year of therapy. If successful, the program could provide Marion Merrell Dow with some protection from future generic competition as well as from market share inroads by the other branded calcium channel blockers. The patent for diltiazem expired in February 1988. Marion, however, maintains exclusivity from ANDA competition until November 1992 due to the transition provisions of the Waxman/Hatch Act. A full NDA attack on the Cardizem brand was being mounted by Bolar (in conjunction with Rorer) prior to the allegations of fraud brought against the generic firm.
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