Formulary Watch |

PBMs are putting weight loss drugs, including Wegovy and Zepbound, on their national formularies, but coverage by plans is uneven. What is needed is more data about whether these drugs can lower overall healthcare costs.

The IQVIA analysis finds that the impact of drug price negotiation on patients’ out-of-pocket spending could also be smaller than expected.

If approved, elinzanetant would be another non-hormonal option for menopausal women seeking hot flash relief.

Sanjula Jain of Trilliant Health talks about how employers are best positioned to demand value for money from the U.S. healthcare system.

UnitedHealthcare is adding deductibles to Part D prescriptions on certain formulary tiers as a result of plan design changes from the Inflation Reduction Act.

Dry eye disease affects up to 15% of the U.S. population and is one of the largest markets in the ophthalmology field.

Otulfi is the fourth Stelara biosimilar to be approved by the FDA.

Blue Shield of California is purchasing Idacio for a net price of $525 per monthly dose, and most plan members will pay $0 out of pocket.

This is the sixth indication for Dupixent and the only biologic approved in the United States to treat COPD.

KarXT — now with the brand name Cobenfy— is expected to be available in October with a list price of about $22,500 annually. The drug represents a new way to treat adults with schizophrenia.

PSG's Morgan Lee talks about how customers of the Big 3 PBMs report lower satisfaction across most measures, and they are less likely to recommend their PBM.

Clinical data suggests an imbalance in vaso-occlusive crises and fatal events that require further assessment, and the company said it will provide updates in the future.

Aqneursa is the second drug approved within a week to treat Niemann-Pick Disease, Type C.

Novo Nordisk said it’s open to discussions with PBMs based on their commitments that a lower semgalutide list price would not impact formulary coverage.

The FTC said it is focusing on insulin as the “poster child” of a broken system, where PBMs leverage formulary placement to receive higher rebates from pharmaceutical manufacturers.

The FDA has already approved Zoryve cream (0.3% and 0.15%) for plaque psoriasis and atopic dermatitis in adults and children ages 6 and up. Currently, Zoryve foam 0.3% is only approved to treat seborrheic dermatitis in adult and pediatric patients 9 years and older.

Veklury is indicated to treat adults and children who are hospitalized with COVID-19.

This is the first FDA approved medication for the rare and progressive neurodegenerative disease, Niemann-Pick Disease Type C.

Bimzelx was first approved last year for the treatment of moderate to severe psoriasis in adults, making it the first and only IL-17A and IL-17F inhibitor approved in the United States for four autoimmune diseases.

GeneCQ uses integrated medical and pharmacy claims data to provide insight into the exposure to the costs for gene therapies.

Today’s approval means that FluMist is the first pharmacy-prescribed influenza vaccine that does not need to be given by a healthcare professional.

Participants cite the recent, ongoing popularity of GLP-1 drugs prescribed for weight loss.

When CMS begins negotiations for physician-administered drugs under the Inflation Reduction Act, providers, including those whose services are covered by commercial insurance, could see lowered reimbursement.

Whether Express Scripts wins its unique defamation lawsuit will depend on whether the PBM can prove the FTC made false statements. But winning the lawsuit may not be what the PBM is looking for.