Drug Coverage

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.

This is the latest offering by Express Scripts that aims to bring transparency to prescription drug costs.

Bimzelx is the first dual IL-17 A/F inhibitor to treat moderate-to-severe plaque psoriasis. It launches with a list price of $7,200 per syringe.

The results of a recent feasibility study on the outpatient administration of cell therapies is creating growing interest in whether home-based management may be possible in the future.

Beginning Jan. 1, 2024, Cigna Healthcare’s formulary changes mostly impact generics and biosimilars.

In her review of the specialty drug pipeline, Evernorth's Aimee Tharaldson said upcoming approvals for Crohn’s and colitis drugs could further shift the drug spend from the medical benefit to the pharmacy one.

Zurzuvae, the first oral therapy for postpartum depression, will launch in December.

Using an AI platform, Magellan Health was able to better support providers in prescribing behavioral health medications and addressing medication problems, which reduced pharmacy costs and increased adherence.

First in class, biosimilars, oncology drugs and even some generics have been added to Optum Rx’s list of exclusions for 2024.