Specialty Pharmacy Trends to Watch in 2023
Dea Belazi of AscellaHealth talks about the challenges payers will face as they confront the high costs associated with specialty drugs.
Patients Often Lose in the Battle between Pharma and PBMs
Over the last five years, both PBMs and drug manufacturers have implemented restrictions that put more of the costs for specialty medications on patients.
Optum Rx to Provide Weight Loss Management Program
Optum Rx standard formularies currently include the weight loss drugs Wegovy and Saxenda, and the PBM is evaluating Zepbound.
Semaglutide for Weight Loss: To Cover or Not Cover?
Ozempic, Wegovy and other GLP-1 drugs present a challenge to payers in terms of costs and outcomes, finds PSG’s new Drug Benefit Design Report.
Analysis: PBMs Block Access to Lantus Biosimilars
An analysis by Biosimilars Council has found that the reference product Lantus accounts for 54% of new prescriptions and is 78% of total market volume but demand for the unbranded interchangeable insulin glargine is increasing.
Alex Jung: It’s time to Think Differently about Specialty Drugs
Employers and plans need to prioritize clinical efficacy over drug price, look for price reductions — and not rebates — on biosimilars, and advocate for a public option to cover gene therapies. These are just a few of ideas that consultant Alex Jung put forward at a meeting of the Midwest Business Group on Health.
Are PBMs Putting GLP-1 Drugs on Their Formularies?
October 11th 2024PBMs 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.
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