SI
SI
discoversearch

We've detected that you're using an ad content blocking browser plug-in or feature. Ads provide a critical source of revenue to the continued operation of Silicon Investor.  We ask that you disable ad blocking while on Silicon Investor in the best interests of our community.  If you are not using an ad blocker but are still receiving this message, make sure your browser's tracking protection is set to the 'standard' level.
Biotech / Medical : PFE (Pfizer) How high will it go? -- Ignore unavailable to you. Want to Upgrade?


To: Zebra 365 who wrote (3716)6/24/1998 6:45:00 PM
From: Hunter Vann  Respond to of 9523
 
Pfizer made the Dueling Fools this week....

fool.com



To: Zebra 365 who wrote (3716)6/26/1998 12:14:00 AM
From: Ibnbatutaa  Respond to of 9523
 
Zebra, Zurdo and co: good discussion, many valid points. The fact is that the HMO / Managed Care plans became very popular with Employers (as opposed to indemnity) during the last recession because of health-care cost inflation which was one factor in declining profits, easy to target, with a ready solution available: managed -care. Managed-care has controlled health-care inflation by drastically reducing payment to providers (docs and hospitals, and shifting risk to them (capitation)), and to some extent by pharmacy benefit management (using generics, or formulary (preferred) drugs because a drug company gives a better deal for an exclusive contract to supply one of several available drugs in a class).
The financial model HMOs use does not allow much room for the use of the more expensive newer drugs (e.g. Viagra) or other technologies. In some cases (cancer treatment particularly) refusing treatment would be a public-relations disaster, so they generally don't, and instead shift the financial risk burden to the hospital or doctor). With ED they are using the "not medically necessary" argument at the moment, "a quality of life issue". Well, pain management too is a quality of life issue and they don't refuse to cover that.
I think what these declining HMOs are doing is waiting for the renewal season, when they'll make sure the premiums cover this; and also trying to force Pfizer to reduce the price of the drug. There are many drugs which are far more expensive when total cost is considered (per month). So I'm sure they'll all cover it eventually, maybe with some limit as per United Health Care.
Finally I don't think any large employer is going to change HMOs because Viagra is not covered (unless the CEO, HR folks need it!). They look at their bottom-line / expense first, then the broad plan coverage options, not the smaller details.
Thanks for reading this.
Regards
Ibnbatutaa