November 30th 2023
A new survey finds that more people are using semaglutide and other GLP-1 therapies to lose less than 15 pounds.
Although biosimilars have already generated savings for Medicare Part B programs and beneficiaries, opportunities for substantial reductions in spending remain, according to a report from the HHS.
November 29th 2023
Adzynma is a recombinant protein designed to replace the deficient ADAMTS13 enzyme to treat patients with the rare hereditary blood clotting disorder congenital thrombotic thrombocytopenic purpura
November 24th 2023
A recent report predicts there could be an increase in premiums for Medicare Part D prescription drug plans in California, Florida, New York, Pennsylvania and Texas.
November 23rd 2023
A simulation study estimated the impact of biosimilar substitution on total cost of care and provider financial performance in the final performance period of the Oncology Care Model.
Ohio Sues Express Scripts and Prime Therapeutics For Price Fixing
The suit alleges that Express Scripts, Prime and Prime customer Humana Pharmacy Solutions are able to share drug pricing and rebate information to increase prices for insulins, biologics and cancer drugs.
Generics Keep Out-of-Pocket Costs Low for Women with Breast Cancer
Out-of-pockets costs were higher among those using branded or more recently launched drugs.
RxBenefits Provides New Solutions to Facilitate Access to Patient Assistance Programs
RxBenefits helps patients in self-funded plans find and apply for alternative sources of funding for specialty medicines and facilitates enrollment.
Committee Sends PBM Transparency Bill to Full Senate
The proposed legislation, sponsored by Sens. Chuck Grassley and Maria Cantwell, aims to increase transparency of PBM business practices.
Sanofi Slashes Lantus List Price by 78%
The company also will establish a $35 cap on out-of-pocket costs for Lantus for all patients with commercial insurance.
Hemophilia Groups Protest BCBS of Tennessee Formulary Exclusions
The patient groups say the insurer is cutting off access to important medications. The Tennessee Blues plans say many of the drugs that it excluded from coverage have zero utilization.
HHS Names 27 Drugs Subject to Medicare Inflation Rebates
Medicare Part B beneficiaries are expected to save between $2 and $390 per average dose starting April 1, 2023.
Novo Nordisk Cuts Price on Several Insulin Products by 75%
The lower prices will take effect on Jan. 1, 2024, on both pre-filled pens and vials of basal, bolus and pre-mix insulins, including Levemir, Novolin, NovoLog and NovoLog Mix 70/30.
VA to Cover the Alzheimer’s Drug Leqembi
The VA’s guidelines would exclude anyone who has had a stroke or seizure within the last year, as well as those who have MRIs that show evidence of microhemmorrhages, aneurysms, lesions or tumors.
CMS Grants Aponvie Pass Through Status
Aponvie is the first intravenous version of aprepitant adults to prevent postoperative nausea and vomiting.
CMS Grants Pass-through Reimbursement for Iheezo
Iheezo, approved in September 2022, is an ocular surface anesthesia used during cataract surgeries.
VA Adds ALS Therapy Radicava ORS to National Formulary
Radicava ORS will be available with a national prior authorization process in place.
Payers Want Value from Pharma Specialty Programs, Surveys Find
Payers are looking to pharmaceutical companies for innovative partnerships that provide patient access, positive clinical outcomes and reduced costs in specialty disease areas, AmerisourceBergen finds.
Patients Oppose Prior Authorization Policies, Finds New Poll
The majority of consumers surveyed by Let My Doctor Decide support reforms to improve access and affordability.
Updated ICER Analysis Shows Leqembi Still Not Cost-Effective
Leqembi would need a 66% to 19% discount from its wholesale acquisition cost of $26,500 a year to fall within commonly used cost-effectiveness thresholds.
Updated: Lilly Cuts Prices of Some Insulins and Caps Out-of-Pocket Costs
The price cuts apply to Lilly’s nonbranded insulin, Humalog, Humulin and its Lantus biosimilar.
Study: Health Plans Align with ICER’s Drug Cost-Effectiveness Ratios
Investigators found an association between ICER’s value assessments and how U.S. commercial health plans cover specialty drugs.
PCMA Defends PBMs with Seven-Figure Ad Campaign
The ads focus on how PBMs promote competition in the prescription drug marketplace and provide choice for employers.
Formulary Placement and Outcomes to Drive Physician Use of Humira Biosimilars
Bruce Feinberg, D.O., of Cardinal Health, said significantly changes are on the horizon for biosimilars, but physician comfort with and use of biosimilars will depend on things beyond their control, including formulary placement and utilization management efforts.
CMS Maintains Limited Coverage for Alzheimer’s Drugs
CMS said it will cover monoclonal antibodies to treat Alzheimer’s disease if they are approved through the standard review process and not through an accelerated approval.
Moderna to Offer Free COVID-19 Vaccine for Uninsured
The U.S. public health emergency response to COVID-19 ends May 11, 2023, and the transition to more traditional healthcare coverage will begin later this year.
ICER Gives NASH Drug Resmetirom High Marks, Obeticholic Acid Not So Much
At a placeholder price of $19,000, resmetirom would produce cost savings, says the drug evaluation group. Obeticholic acid’s price would need to be slashed to meet a commonly used cost-effectiveness threshold.
Mark Cuban Assails PBMs at AAM meeting
Cuban, of "Shark Tank' fame and owner of the Dallas Mavericks, called drugs prices ‘insane’ and used some profanity when talking pharmacy benefit managers at the annual meeting of the Association for Accessible Medicines yesterday. Cuban has co-founded an online pharmacy that he says will make drug prices lower and transparent.
Navitus Adds Biosimilar Amjevita to Formulary
Navitus will be accessing the Humira biosimilar Amjevita through the lower wholesale acquisition cost option.
PBMs in the Spotlight at Senate Hearing
Senators want more insight into PBM practices and the role they play in the healthcare ecosystem.
How Personalized Medicine Can Accelerate the Shift to Value-Based Care
Abarca's Nicole (Gupta) Bulochnik, Pharm.D., talks about how personalized medicine could be integrated into value-based care to accelerate uptake.
Value-based Outcomes Contracts Can Address High-Cost Gene Therapies
Javier Gonzalez, Pharm.D., at Abarca Health, talks about how value-based pricing arrangements can align incentives among stakeholders for specialty disease management.
CVS Caremark Removes 5 Brands from Drug List
The branded therapies were removed in favor of generics effective April 2023. CVS Caremark also added 13 generics to its Performance Drug List.
Sen. Cantwell to Hold Hearing on PBMs
The hearing will discuss the role of PBMs in healthcare and the Pharmacy Benefit Manager Transparency Act, legislation that has been submitted by Sens. Maria Cantwell and Chuck Grassley.
Ferring Launches First Microbiome Therapy to Prevent C. Diff Infection
No list price was provided for Rebyota but Ferring is offering copay and patient assistance programs.
2 Clarke Drive Cranbury, NJ 08512