Denise Myshko

Tremfya is also approved to treat patients with plaque psoriasis, active psoriatic arthritis and ulcerative colitis and is available as both a subcutaneous and intravenous induction option.

Optum Rx's new cost-based program uses an internal algorithm that leverages multiple available industry data sources, such as NADAC and PAC, to inform reimbursement.

Optum Rx has eliminated reauthorization for almost 70 drugs for chronic diseases, about 10% of its overall pharmacy prior authorizations.

Regulators are expected to make a decision in the third quarter of 2025 on Kerendia to treat patients with heart failure with a left ventricular ejection fraction (LVEF) of ≥40%.

At a Senate confirmation hearing for CMS administrator, Mehmet Oz, M.D., would not answer directly whether he would support budget cuts to the Medicaid program.

Lumicera Health Services, Navitus’ specialty pharmacy, has made a deal with Teva to offer an unbranded biosimilar that they estimate will save $112,000 and $336,000 per patient per year. Navitus will remove Stelara from formulary on July 1, 2025.

The new bill would also require state Medicaid programs to report National Average Drug Acquisition Costs (NADAC) as a way to increase transparency in drug pricing.

Two companies have received approved for a generic of the 2.5 mg tablet of anticoagulant rivaroxaban, which is used to reduce the risk of stroke and deep vein thrombosis.

More than 200 products from 28 makeup, sunscreen, and shaving cream brands contained Teflon and other forever chemicals, according to a new study presented at the American Academy of Dermatology annual meeting.

Of the states that provide coverage for JAK inhibitors used to treat patients with alopecia, researchers found that prior authorization is required by an overwhelming majority of plans, according to an analysis presented at the American Academy of Dermatology annual meeting.

In this analysis presented at the American Academy of Dermatology annual meeting, serious adverse events were low, unrelated to cream strength, and generally reflective of background rates in the broader population with atopic dermatitis.

A break from treatment with Vtama won’t lead to worsening of patients’ atopic dermatitis, finds a new analysis of an open-label study.

NovoCare Pharmacy will provide all dose strengths of Wegovy at a reduced cost of $499 per month for cash-paying patients without insurance.

The FDA had approved Otulfi in September 2024 to treat Crohn’s disease, ulcerative colitis, psoriasis and active psoriatic arthritis. Information on pricing is not yet available.

The Institute for Clinical and Economic Review has prepared a special report on Trelegy and Breo, two therapies that treat patients with chronic obstructive pulmonary disease that are part of CMS's drug price negotiation program.

A protein called NF-kB c-Rel has been found to intensify the symptoms of psoriasis, offering a potential new target for treatments.

Selarsdi and Yesintek have launched this month at prices that are 85% and 90% off the cost of Stelara.

Blue Cross Blue Shield of Michigan said it is evaluating any potential updates to the coverage process for Darzalex Faspro and there are no changes at this time.

At what was supposed to be a hearing to discuss PBM reform, some in Congress veered off into discussions about Medicaid and maternal health, and even Elon Musk.

The new lower prices apply to some doses of Zepbound provided in vials but not the autoinjector pens.

There are four biosimilars of Stelara available to treat chronic autoimmune diseases — Wezlana, Selarsdi and now Pychiva and Yesintek.

Teva and Alvotech are introducing Selarsdi at an 85% discount off the reference product Stelara. Selarsdi is available as a subcutaneous injection and for intravenous infusion.

Gaps in funding caused by the potential $5 billion budget cut to the National Institutes of Health would be “almost impossible” to fill, according to Aaron J. Kowalski, Ph.D., CEO of Breakthrough T1D.

Merilog is expected to be available in July 2025, and Sanofi will provide Merilog to patients for $35 or less for a 30-day supply.

Aaron J. Kowalski, Ph.D., CEO of Breakthrough T1D, spoke with Managed Healthcare Executive, about the possible impacts of the NIH’s cuts to indirect research funding.

So far, five biosimilars that reference Eylea 2 mg have been approved by the FDA. Alvotech/Teva expect to regulatory approval for its biosimilar to be completed in the fourth quarter of 2025.

Samsung Bioepis’ biosimilars Ospomyv and Xbryk have been approved to be interchangeable with Prolia/Xgeva treat osteoporosis and multiple myeloma/bone metastases from solid tumors.

Those voting to support Robert F. Kennedy Jr as Secretary of HHS include Louisiana Republican Sen. Bill Cassidy. Mitch McConnell, a Republican from Kentucky, however, voted no.

Just as Andrew Witty of UnitedHealth Group did in a call with investors last month, CVS Health’s CEO David Joyner defended the role of PBMs in healthcare.

CVS Health’s healthcare benefits segment, which includes Aetna, had medical benefit ratio of 92.5% in 2024, because of higher utilization, an unfavorable impact of Medicare Advantage star ratings payment and higher levels of care in Medicaid.