Allergy, Immunology, and ENT

COPD

Cardiovascular

Clinical Pharmacology

Dermatology

Diabetes and Endocrinology

Drug Coverage

Idiopathic Pulmonary Fibrosis

Musculoskeletal/Rheumatology

Obstetrics-Gynecology & Women's Health

Oncology

Ophthalmology

Pediatrics

Pharmacy

Psychiatry and Behavioral Health

Regulatory Updates

Respiratory

Safety & Recalls

Urology

News

Media

Expert Interviews

Medical World News

Podcasts

CME/CE

Subscribe

Conference

Conference Listing

Advertise

Editorial Info

Contact Us

Terms & Conditions

Privacy Policy

Do Not Sell My Personal Information

Formulary Watch

Twitter

Facebook

RSS Feed

Spotlight

Clinical

Musculoskeletal / Rheumatology

1rem

Articles

Three commercial plans now cover the corticosteroid Eysuvis.

New Dry Eye Therapy Gains Formulary Coverage 

Zymfentra launched in March 2024 as the first subcutaneous formulation of infliximab for patients with ulcerative colitis and Crohn’s disease. It has a list price of $6,181.08 for two shots over four weeks.

Express Scripts Adds Zymfentra to National Preferred Formulary

Walgreens is expanding its specialty pharmacy services and renaming AllianceRx Walgreens Pharmacy as Walgreens Specialty Pharmacy.

Walgreens to Offer Cell and Gene Therapy Services 

Beginning in June 2024, Quallent Pharmaceuticals will provide Evernorth a high- and low-concentration interchangeable biosimilar of Humira.

Evernorth to Offer Private Label Humira Biosimilar

New White Paper looks at the solutions and policy options of how to pay for high-cost gene therapies when there is still so much uncertainty about the outcomes and the durability of clinical benefits.

 No Silver Bullet for Paying for Gene Therapies

Researchers were unable to find a significant benefit for patients for the majority of cancer medications given accelerated FDA approval.

Most Cancer Drugs With Accelerated Approval Don’t Show Benefit 

Chris Blackley, co-founder and chief executive officer of Prescryptive Health, a drug benefits technology company, discusses the states that developing legislation that put requirements on PBMs. “One of the most positive things coming out of the state level activity and engagement is the awareness and education of the market,” commented Blackley. “It's only recently within the last few years that people even know what a PBM is.”

New York, he said, is being active in this area, where they are establishing policy that requires PBMs and payers to provide to patients in real-time information that about their prescriptions. This is important because it address access barriers related to pricing. “A lot of legislation in the past has focused on the patients and the provider. Giving patients information in this way will have a much bigger impact. New York is the first state doing this and when others see the impact of doing that, many will follow.”

In addition, states are moving gag clauses, which are written into pharmacy contracts with PBMs and prohibit pharmacists from telling a patient when paying by cash may be less expensive than using insurance. “Gag clauses are another way of putting the pharmacy in jeopardy when they are not being reimbursed at a fair price. Pharmacies are dependent upon major companies for as much as 25%, 30%, 40% of their revenue. If a small, independent pharmacy loses a contract, they go out of business.”

But he says, we have to be careful that policies that try to solves these programs to make sure they don’t become so burdensome so that people can’t afford to drive positive change.

Videos

Chris Blackley, co-founder and chief executive officer of Prescryptive Health, discusses the laws that states that are implementing to restrict PBM practices and the impact on patients and employers.

Blackley on the Impact of State PBM Regulations

In this video, Dea Belazi, president and chief executive officer of AscellaHealth, discusses how payers will approach specialty drugs.

Payers and Specialty Drugs

Drug Coverage

Latest News

More News