Formulary Watch |

Formulary Watch covers formularies, pharmacy benefit management companies, drug approvals, and other matters related to medications, their prices and insurance coverage.

Editorial Contact: Denise Myshko: dmyshko@mjhlifesciences.com

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NDA Resubmitted for Dry Eye Treatment Reproxalap
NDA Resubmitted for Dry Eye Treatment Reproxalap
October 3, 2024
Dry eye disease affects up to 15% of the U.S. population and is one of the largest markets in the ophthalmology field.
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Stelara Biosimilar Otulfi Approved by FDA to Treat Multiple Autoimmune Disorders
Stelara Biosimilar Otulfi Approved by FDA to Treat Multiple Autoimmune Disorders
October 1, 2024
Otulfi is the fourth Stelara biosimilar to be approved by the FDA.
Blue Shield of California to Offer Humira Biosimilar Idacio
Blue Shield of California to Offer Humira Biosimilar Idacio
Blue Shield of California to Offer Humira Biosimilar Idacio
October 1, 2024
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.
FDA Approves Dupixent for Patients with COPD
FDA Approves Dupixent for Patients with COPD
FDA Approves Dupixent for Patients with COPD
September 27, 2024
This is the sixth indication for Dupixent and the only biologic approved in the United States to treat COPD.
FDA Approves the Oral Medication KarXT for Schizophrenia
FDA Approves the Oral Medication KarXT for Schizophrenia
FDA Approves the Oral Medication KarXT for Schizophrenia
September 27, 2024
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.
Survey Finds Payers are Looking for Change in Pharmacy Benefits
Survey Finds Payers are Looking for Change in Pharmacy Benefits
Survey Finds Payers are Looking for Change in Pharmacy Benefits
September 26, 2024
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.
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Pfizer Withdraws Sickle Cell Drug Oxbryta from Market
Pfizer Withdraws Sickle Cell Drug Oxbryta from Market
September 26, 2024
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.
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FDA Approves Second Drug to Treat Rare Neurodegenerative Disease
FDA Approves Second Drug to Treat Rare Neurodegenerative Disease
September 25, 2024
Aqneursa is the second drug approved within a week to treat Niemann-Pick Disease, Type C.
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Takeaways from Senate Hearing on Semaglutide Pricing
Takeaways from Senate Hearing on Semaglutide Pricing
September 25, 2024
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.
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The FTC Insulin Case is About Access — and Rebates
The FTC Insulin Case is About Access — and Rebates
September 25, 2024
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.
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FDA Accepts sNDA for Foam Psoriasis Drug Zoryve
FDA Accepts sNDA for Foam Psoriasis Drug Zoryve
September 24, 2024
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.
Glass in Vial Leads to Recall of One Lot of Veklury
Glass in Vial Leads to Recall of One Lot of Veklury
Glass in Vial Leads to Recall of One Lot of Veklury
September 24, 2024
Veklury is indicated to treat adults and children who are hospitalized with COVID-19.
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FDA Approves Miplyffa for Ultra Rare Niemann-Pick Disease Type C
FDA Approves Miplyffa for Ultra Rare Niemann-Pick Disease Type C
September 23, 2024
This is the first FDA approved medication for the rare and progressive neurodegenerative disease, Niemann-Pick Disease Type C.
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FDA Expands Bimzelx Approval to Three Additional Autoimmune Indications
FDA Expands Bimzelx Approval to Three Additional Autoimmune Indications
September 23, 2024
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.
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PSG Launches Solution to Assess Payers’ Gene Therapy Risk
PSG Launches Solution to Assess Payers’ Gene Therapy Risk
September 23, 2024
GeneCQ uses integrated medical and pharmacy claims data to provide insight into the exposure to the costs for gene therapies.
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FDA Approves FluMist Vaccine for Self-Administration
FDA Approves FluMist Vaccine for Self-Administration
September 20, 2024
Today’s approval means that FluMist is the first pharmacy-prescribed influenza vaccine that does not need to be given by a healthcare professional.
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Employers Predict Drug Prices Will Increase in 2025, Survey Shows
Employers Predict Drug Prices Will Increase in 2025, Survey Shows
September 20, 2024
Participants cite the recent, ongoing popularity of GLP-1 drugs prescribed for weight loss.
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Medicare’s Drug Price Negotiations Could Impact Physician Reimbursement
Medicare’s Drug Price Negotiations Could Impact Physician Reimbursement
September 19, 2024
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.
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Can Express Scripts Win its Lawsuit Against the FTC?
Can Express Scripts Win its Lawsuit Against the FTC?
September 18, 2024
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.
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FDA Approves Fasenra for Treatment of Eosinophilic Granulomatosis with Polyangiitis
FDA Approves Fasenra for Treatment of Eosinophilic Granulomatosis with Polyangiitis
September 18, 2024
More than half (60%) of patients in latest trial reached active remission and 41% stopped taking corticosteroid entirely.
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Express Scripts Sues FTC to Withdraw its PBM Report
Express Scripts Sues FTC to Withdraw its PBM Report
September 17, 2024
Express Scripts alleges in its suit that the FTC followed “prejudice and politics, not evidence or sound economics,” and that there is no support for the assertion that the power of PBMs has increased over time.
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Prime Program Connects Patients with Financial Solutions for Specialty Drugs
Prime Program Connects Patients with Financial Solutions for Specialty Drugs
September 16, 2024
The new program, which begins in January 2025, provides members of Prime Therapeutics support for navigating utilization management requirements and finding financial assistance.
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Survey: One-Third of Adults Say They Don’t Need Fall Vaccines
Survey: One-Third of Adults Say They Don’t Need Fall Vaccines
September 16, 2024
An Ohio State University survey found that many adults are hesitant about getting flu, COVID-19, pneumococcal and respiratory syncytial virus (RSV) vaccines.
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FDA Approves Subcutaneous Ocrevus for Multiple Sclerosis
FDA Approves Subcutaneous Ocrevus for Multiple Sclerosis
September 13, 2024
Ocrevus Zunovo can be administrated by providers twice a year with a 10-minute subcutaneous injection. Ocrevus Zunovo will be available in a few weeks and be priced at parity with Ocrevus IV.
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