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MHE Pharmacy Survey 2021

In this final part of the 2021 Pharmacy Survey slideshow series, participants shared their opinions on which federal policies they favor as a way to curb drug prices and which policy is more likely to occur this year.

The majority of respondents (23%) said requiring PBMs to reimburse pharmacies at or above pharmacies’ drug acquisition costs, is a policy they favor most as a way to curb drug prices. Other policies most favored were: restricting the use of copay accumulator programs (20%), putting limits on drug price increases (20%), negotiating Medicare drug prices (12%), putting limits on out-of-pocket costs for Medicare beneficiaries (11%), mandating transparency in coverage rules (8%), and
linking Medicare Part B drug prices to prices paid in other countries (the Most Favored Nation model) (7% ).



2021 Managed Healthcare Executive® Pharmacy Survey: Drugs New to the Market Most Likely to Reduce Morbidity, Mortality



When asked which federal policy will most likely occur in 2021, most respondents (29%) favored towards limiting on out-of-pocket costs for Medicare beneficiares. Following policies were: Most Favored Nation model for Medicare Part B drugs (23%), federal limits on drug price increase (21%), none of the above (10%), CMS negotiating Medicare drug prices (9%), and no substantial federal policy change will occur (9%).

Just over 225 people responded to our online survey between April 5 and May 10.


Slideshows

In this final part of the MHE 2021 Pharmacy Survey, participants share their thoughts on which federal policies they favor as a way to curb drug prices and which policy is more likely to occur this year. MHE's annual pharmacy survey had over 225 respondents. 



2021 Managed Healthcare Executive® Pharmacy Survey: What Federal Policy Will Most Likely Occur in 2021, Which Will Curb Drug Prices?

The U.S. Supreme Court issued a ruling this morning upholding the ACA.

The Associated Press reported that the justices, in a 7-2 vote, ruled that Texas, other Republican-led states and individuals didn’t have a right to bring their suit in federal court.

This is the third time that the Supreme Court has heard a legal challenge to the 2010 law and left the law intact

The court ruling did not take up the larger issues in the case, California v. Texas, and the question of whether one provision was legally "severable" from the rest of the sprawling healthcare legislation. 

Instead, the justices decided that the plaintiffs lacked standing to bring a constitutional challenge. 

, which was joined by two Trump-appointed justices, Brett Kavanaugh and Amy Coney Barrett. Justice Samuel Alito wrote a dissenting opinion, which was joined by Justice Neil Gorsuch. 

"After numerous legal challenges and efforts to repeal it, the ACA stands and is as popular as it has ever been," tweeted Larry Levitt, executive vice president for health policy for the Kaiser Family Foundation.

Articles

The nation's highest court has upheld the ACA three times.

U.S. Supreme Court Upholds the ACA

MHE Pharmacy Survey 

In this portion of MHE's survey, respondents gave their opinions on which drugs newer to the market in the last 12 months hold the most promise to reducing morbidity and mortality. Participants also shared which drug in the pipeline holds the most promise.

Related: 2021 Managed Healthcare Executive® Pharmacy Survey: Biggest Driver in Specialty Drugs, Contract Changes Between Plan Sponsors and PBMs

Majority of respondents (26%) said Imcivree (setmelanotide), a drug for rare forms of obesity, would have the most promise to reduce morbidity and mortality when asked. Twenty-two percent of respondents said Oxlumo (lumasiran), a drug that treats primary hyperoxaluria type 1, shows more promise. Remaining respondents were for Zokinvy (lonafarnib) (22%), which is for rare conditions related to premature aging; 21% were for Orgovyx (relugolix), for prostate cancer; and 10% were for Evrysdi (risdiplam), a drug for spinal muscular atrophy.

When asked which drug in the pipeline shows more promise, participants responded with Farxiga (dapagliflozin), which treats chronic kidney disease in adults with or without type 2 diabetes, with a percentage at 35%. Roxadustat, a drug that treats anemia associated with chronic kidney disease, followed shortly behind at 31%. Participants (24%) also said Teplizumab, which is used for the prevention of type 1 diabetes, shows promise; while Valoctocogene roxaparvovec, a drug for severe hemophilia A, trailed behind at 24%.

Just over 225 people responded to our online survey between April 5 and May 10.

In this part five series, participants give their opinions on which drugs newer to the market in the last 12 months hold the most promise to reducing morbidity and mortality. Participants also shared which drug in the pipeline holds the most promise. MHE's annual pharmacy survey had over 225 respondents. We will be posting the results over the next few days.



, founded in 2018 as a nonprofit supplier of generic drugs to hospitals, announced today that it was expanding its fledging retail generics business to include a partnership with Anthem and has officially named the retail subsidiary CivicaScript.

, J.D., has been named president of CivicaScript. Prior to CivicaScript, Guinasso had been senior vice president of commercial and Medicare formulary strategy for OptumRx, the UnitedHealth Group’s PBM. Her LinkedIn page says she started at CivicaScript in May.

This morning’s press release also announced that Civica Rx has entered into a long-term partnership with 

 a drug development and manufacturing company headquartered in Somerset, New Jersey.

Civica announced last year that it was branching out from its hospital business  into the retail market in partnership with the Blue Cross Blue Shield Foundation and 17 Blues plans. But today's news elevates the profile of the subsidiary and may foreshadow it becoming a disruptive force in the generics market. With the addition of Anthem, the CivicaScript subsidiary will have insurance partners that cover about 100 million lives.

The press release says that CivicaScript will start by developing and manufacturing six to 10 common, high-priced generics and that they will be available as early as 2022 through retail and mail-order pharmacies. “Using a cost-plus and price transparent model, CivicaScript … plans to innovate and further transform the supply chain to lower the cost of prescription medicines,” the press release says..

The announcement says all of Civica Rx’s hospital system members will have access to the retail medications manufactured by the newly named subsidiary. More than 50 hospital systems that comprise 1,400 hospitals are Civica Rx members.

Catalent will develop a range of CivicaScript-owned generic Abbreviated New Drug Applications, according to he press release, and production will take place at the company’s facilities in Somerset and in Winchester, Kentucky.

“We are delighted to welcome our newest partners and our new CivicaScript president, Gina Guinasso, a nationally revered managed healthcare executive,” Martin VanTrieste, Civica Rx’s president and CEO, said in the press release.

Civica Rx was a founded by seven health systems (CommonSpirit Health, HCA Healthcare, Intermountain Healthcare, Mayo Clinic, Providence St. Joseph Health, SSM Health and Trinity Health) and three philanthropies (the Laura and John Arnold Foundation, the Peterson Center on Healthcare and the Gary and Mary West Foundation). Kaiser Permanente and Memorial Hermann Health have since joined these organizations on its board of directors.

Former OptumRx executive, Gina Guinasso, J.D., is president of the newly named retail venture.

MHE Staff

Articles

2021 Managed Healthcare Executive® Pharmacy Survey: What Federal Policy Will Most Likely Occur in 2021, Which Will Curb Drug Prices?

U.S. Supreme Court Upholds the ACA

2021 Managed Healthcare Executive® Pharmacy Survey: Drugs New to the Market Most Likely to Reduce Morbidity, Mortality

Civica Rx Adds Anthem and Calalent As Partners, Names Its Retail Arm CivicaScript