Wash. Post: Pentagon reviewing its drug coverage; Nexium first casualty

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In a price-slashing move that could mark the first of several cuts to its pharmaceutical budget, the Pentagon is dropping AstraZeneca's heartburn drug Nexium from the list of drugs it covers for military personnel and their families, The Washington Post reports. Instead, the Defense Department will switch patients to one of four less-costly heartburn therapies – Santarus' Zegerid, Wyeth-Ayerst's Protonix, Eisai and Janssen's Aciphex or TAP's Prevacid. The Pentagon says the decision, slated to take effect this summer, will affect about 144,000 beneficiaries taking Nexium and save tens of millions of dollars. According to the Post, the move signals a cultural shift for the military, which in the past has covered "virtually every legal medication." With $379 million of its drug spending going toward proton pump inhibitors (PPIs) last year, the category represented low-hanging fruit for the Defense Department, which says it plans similar reviews of other categories. Next on the block could be expensive versions of drugs for illnesses such as skin infections, hypertension and erectile dysfunction. In the case of Nexium, a Pentagon team of doctors and pharmacists determined there were no significant differences clinically among drugs in the class, yet Nexium was far more costly. An AZ spokesman told the Post that the company did not bid on the military contract because the Pentagon based its decision solely on price. He also disputed assertions that Nexium is essentially the same as other PPIs. The "Purple Pill" will still be available to Pentagon beneficiaries, with approval from their doctor, if they don't see relief from the alternative therapies.
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