Drug Coverage

Peter Rubin of No Patient Left Behind worries that patients may not see benefits, either in lowered costs or continued investment in new therapies, from drug price negotiations required under the Inflation Reduction Act.

Airsupra is an anti-inflammatory rescue medication that can treat the symptoms of asthma while helping to prevent an attack.

A 2020 rule stands in which copay assistance from pharmaceutical companies counts toward deductibles for brand name drugs without a generic competition.

IQVIA’s most recent Global Use of Medicines report projected that market introductions of new biosimilar and generic drugs will increase projected losses for originator products from $111 billion to $192 billion over the next five years.

Adstiladrin delivers a gene that encodes for the interferon alpha-2b protein, and it provides an option for those at high risk of recurrence and metastatic bladder cancer.

Less flexible plans, such as health maintenance organizations, are more likely to use biosimilar therapies than more flexible plans.

Vevye is a water- and preservative-free solution of cyclosporine, which allows for improved bioavailability.

Clients are cautious about how the cost in “cost-plus” programs is determined, how rebates factor in and the benchmarks used, says Navitus’s Brent Eberle.

The transaction is valued at about $575 million. The sale is part of Rite Aid’s restructuring plan after filing for bankruptcy in October 2023.

CVS Caremark has entered into an agreement with AbbVie, the manufacturer of Humira, to supply Cordavis with Humira to develop a cobranded product. Cordavis is a CVS company developing private label therapies.

Zilbrysq has a list price $1,047.19 for a 23 mg syringe. It is UCB’s second treatment for patients with myasthenia gravis.

Nonprescription RiVive was approved in July 2023 to reverse opioid overdose. Harm Reduction is donating 200 doses to Remedy Alliance for distribution.

Additionally, the FDA has approved Avzivi — the fifth biosimilar that references the cancer drug Avastin.

Zurzuvae has a list price of $15,900 for a 14-day course of treatment. No coverage information has been released.

Drug prices and the practices of PBMs are among the concerns expressed by employers who responded to the Pulse of the Purchaser survey by National Alliance of Healthcare Purchaser Coalitions.

Optum Rx standard formularies currently include the weight loss drugs Wegovy and Saxenda, and the PBM is evaluating Zepbound.

Eight of 10 drugs reviewed by Institute for Clinical and Economic Review were not supported by clinical evidence.

IQVIA’s Michael Kleinrock and experts at RxBenefits reveal during webinar top pharmacy trends going into 2024.

Researchers suggest a head-to-head comparative effectiveness study of Ocrevus and Rituxan/biosimilars in patients with multiple sclerosis is needed for payers to negotiate prices for these therapies.

CarelonRx says it will be able provide optimal support for members because, as a PBM, it as able to communicate directly with members’ providers.

Zepbound, which was approved last month to treat obesity, is now available in U.S. pharmacies.

A new survey finds that more people are using semaglutide and other GLP-1 therapies to lose less than 15 pounds.

Although biosimilars have already generated savings for Medicare Part B programs and beneficiaries, opportunities for substantial reductions in spending remain, according to a report from the HHS.

Adzynma is a recombinant protein designed to replace the deficient ADAMTS13 enzyme to treat patients with the rare hereditary blood clotting disorder congenital thrombotic thrombocytopenic purpura

A recent report predicts there could be an increase in premiums for Medicare Part D prescription drug plans in California, Florida, New York, Pennsylvania and Texas.

A simulation study estimated the impact of biosimilar substitution on total cost of care and provider financial performance in the final performance period of the Oncology Care Model.

New biosimilars have been added and others removed from CVS Caremark’s standard formulary. One notable change is with the Humira biosimilars. The PBM has removed Amjevita and now prefers Hyrimoz and an unbranded biosimilar.