Prime Therapeutics Removes Three Drugs from Medicare Formularies


A generic is available for one, and Centers for Medicare & Medicaid Services has removed two others from Medicare Part D coverage.

Prime Therapeutics has removed three prescriptions drugs from its formularies, one because a generic has been available and two because it is no longer covered by Medicare Part D.

The first product removed is Genentech’s Esbriet (pirfenidone) tablets, which is approved to treat patients with idiopathic pulmonary fibrosis, a chronic progressive lung disease. It causes scar tissue to build up in the lungs, which makes the lungs unable to transport oxygen into the bloodstream effectively

Two generics are now available. The first generic was Sandoz’s oral pirfenidone, which was launched in May 2022. This was followed by the launch of Accord Healthcare’s pirfenidone oral.

The Prime formularies impacted include: Ideal, Value, Value Plus Formularies & Essential Center of Excellence Formularies.

Two additional products are no longer covered by Medicare Part D, according to Prime. Prime has removed them from all formularies. These include Oravig tablets and Zuplenz film. Oravig (miconazole) treats oral fungal infections and is marketed by Galt Pharmaceuticals. No generic is available, but the patents that cover the product are set to expire in September 2022.

Zuplenz (ondansetron) has been discontinued by the manufacturer, Aquestive Therapeutics, formerly called MonoSol Rx.

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