Formulary Watch |

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.

More than half (60%) of patients in latest trial reached active remission and 41% stopped taking corticosteroid entirely.

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.

The new program, which begins in January 2025, provides members of Prime Therapeutics support for navigating utilization management requirements and finding financial assistance.

An Ohio State University survey found that many adults are hesitant about getting flu, COVID-19, pneumococcal and respiratory syncytial virus (RSV) vaccines.

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.

Tecentriq Hybreza will be available in a few weeks and be priced at parity with the IV Tecentriq 1200 mg vial.

The FDA has identified a probable case of serious drug induced liver injury that occurred in a woman in the United States who had received Veozah. The agency is requiring additional liver blood testing after starting therapy.

Tremfya, a monoclonal antibody that blocks IL-23, is also approved to treat patients with plaque psoriasis and active psoriatic arthritis.

If approved, neffy would be the first new delivery method in more than 35 years for small children.

The Inflation Reduction Act’s limit on Medicare Part D spending can lead to savings for patients prescribed oral chemotherapy drugs.

This analysis finds that 57.4 million adults under the age of 65 could potentially be eligible for GLP-1 drugs based on currently approved FDA indications, including 36.2 million people with obesity.

The private-label biosimilar will be available at an 80% discount off Stelara. Evernorth has not released information about which company will be producing the biosimilar.

Outcomes-based agreements can take away clinical uncertainties, so payers have a guarantee that they're not spending money on something that’s not going to work.

The growth of out-of-pocket and insurer/negotiated prices paralleled one another until 2016 when negotiated and insurer prices began declining

Sebetralstat would be the first oral, on-demand treatment for hereditary angioedema if approved.

The new program provides large employers with access to Capital Rx’s technology platform for claim adjudication, invoicing, and reimbursement.

MedImpact is not requiring patients currently taking Humira to switch, and all three products are on a preferred tier.

Zymfentra is a subcutaneous infliximab product used to treat ulcerative colitis and Crohn’s disease. It has a price of $6,181.08 for two shots over four weeks.

The FDA has given mirdametinib a Prescription Drug User Fee Act (PDUFA) action date of Feb. 28, 2025, to treat patients with neurofibromatosis type 1 with tumors that grow along the peripheral nerve.

Through the PfizerForAll platform, patients can connect with a healthcare professional, find and book vaccines, order tests, and find medication savings information.

The monthly price of the 2.5 mg Zepbound single-dose vial is $399 and the 5 mg dose is $549, which Lilly officials said is in line with the savings program for without insurance.

Beginning in 2025, Express Scripts will favor biosimilars of Humira, including its own private-label version.

The updated vaccines include the KP.2 strain of the Omicron variant, which is believed to be contributing to the increases in COVID-19 infections this summer.

Avalere’s Kylie Stengel talks about the regional shifts in formularies and utilization management in Medicare Part D prescription drug plans.

The FDA has assigned a Prescription Drug User Fee Act of Dec. 20, 2024, for Zynquista (sotagliflozin) to control glycemic levels in adults with type 1 diabetes and chronic kidney disease.

The FDA identified at a third party fill and finish manufacturer. The issues have been resolved, and reinspection is expected in the next few months.

This therapy is a first-in-class treatment for chronic graft-versus-host disease, which develops in roughly 42% of those who receive a stem cell of bone marrow transplant.