Drug Coverage

Three products, including Pfizer’s smoking cessation product Chantix, have been removed because generics are now available.

Aetna, Cigna and UnitedHealthcare are enhancing their Medicare pharmacy benefits, including offering insulin for a copay of no more than $35 for a 30-day supply.

Given together, bamlanivimab and etesevimab have an emergency use authorization from the FDA to both treat COVID-19 and prevent infection in those who have been exposed.

Effective Oct. 1, 2021, Aetna has added several cancer drugs to its formulary and has updated exclusions and nonpreferred products.

Comprehensive medication management aided by AI clinical decision support can result in a large return on investment in a high-risk population. In this study, every dollar that was invested resulted in $12 in savings or cost avoidance.

Trudhesa was approved in September to treat migraine.

The enzyme replacement therapy treats Pompe disease, a rare genetic disorder that affects children.

Effective Jan. 1 2022, the move brings the price to 2008 levels.

Prices paid by Veterans Affairs were the lowest and were 50% to 60% below list prices.

Amgen’s Biosimilar Trend Report finds that biosimilars have been introduced at a price that is generally 15% to 37% lower than the reference product.

Shifting cancer patients to the physician setting for administration of cancer therapies could save insurers $1.28 billion.

Takeda Oncology’s Exkivity treats non-small lung cancer in patients with EGFR exon 20 insertion mutations.

Effective October 1, 2021, CMS will reimburse for the infusion product when dispensed in the outpatient setting.

Regeneron also announced an expanded contract with the U.S. government for the purchase of additional doses of REGEN-COV.

The plan will cover administration of the booster for those with cancer or who are immunocompromised.

Alinia and Sutent have been removed from the drug lists because of the introduction of generic therapies.

Real-world data show Erleada prolonged survival in both metastatic and non-metastatic castration-sensitive prostate cancer.

Investigators found patients with COPD taking Anoro Ellipta had low overall on-treatment exacerbation rates, which can reduce medical costs due to increased adherence to therapy.

ICER’s updated analysis uses observational, real-world data for three therapies — Takhzyro, Haegarda, and Cinryze.

American Academy of Sleep Medicine’s guideline recommends Wakix to treat excessive daytime sleepiness and cataplexy in adults with narcolepsy.

Florida’s First Choice Neurology has provided Aduhelm to patients through the Biogen access program.

Bluebook Rx is a new solution that helps employers and plan sponsors better understand and optimize their prescription drug spending.

ICER’s policy recommendations suggest payers establish step therapy with less expensive systemic agents to allow patients and clinicians to choose from multiple options.

The liquid therapy to treat hypothyroidism now comes in 15 different dosage strengths in single-use packaging.

The therapy is the first approved for patients with tumors associated with von Hippel-Lindau disease.