Category Archives: Pharma

Pharmacy Briefing: April 2021

Pharmacy Briefing is a monthly summary of select U.S. Food and Drug Administration (FDA) approvals and launches, treatment guidelines and research updates, and other newsworthy events that have the potential to impact commercial drug utilization or costs.

Highlights

  • Evernorth publishes 2020 Drug Trend Report
  • Fierce Pharma reports highlight top 10 drugs losing patent exclusivity and top 10 most anticipated drug launches in 2021
  • Sanofi publishes 2021 Pricing Principles Report
  •  CMS updates Medicare payment rates for COVID-19 vaccine administration

FDA Approvals and Launches

  • Actemra (tocilizumab) receives additional indication to slow declining pulmonary function in patients with systemic sclerosis-associated interstitial lung disease.
  • Humira (adalimumab) receives additional indication to treat moderate to severe ulcerative colitis in pediatric patients.
  • Ponvory (ponesimod) is approved to treat relapsing forms of multiple sclerosis.
  • Zegalogue (dasiglucagon) is approved to treat severe hypoglycemia in patients with diabetes.

FDA Approvals and Launches

  • Actemra (tocilizumab) receives additional indication to slow declining pulmonary function in patients with systemic sclerosis-associated interstitial lung disease.
  • Humira (adalimumab) receives additional indication to treat moderate to severe ulcerative colitis in pediatric patients.
  • Ponvory (ponesimod) is approved to treat relapsing forms of multiple sclerosis.
  • Zegalogue (dasiglucagon) is approved to treat severe hypoglycemia in patients with diabetes.
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Pharmacy Briefing: March 2021

Pharmacy Briefing is a monthly summary of select U.S. Food and Drug Administration (FDA) approvals and launches, treatment guidelines and research updates, and other newsworthy events that have the potential to impact commercial drug utilization or costs.

Highlights

  • FDA grants Emergency Use Authorization for third COVID-19 vaccine
  • Merck partners with Johnson & Johnson to manufacture COVID-19 vaccines
  • Manufacturers of Plavix (clopidogrel) ordered to pay $834 million to state of Hawaii
  • FiercePharma summarizes the year’s top 10 most anticipated drug launches
  • Semaglutide produces significant weight loss among non-diabetic patients in phase 3 trial

FDA Approvals and Launches

  • Evkeeza (evinacumab-dgnb) is approved to treat a rare form of high cholesterol.
  • Entresto (sacubitril/valsartan) receives additional indication to treat patients with heart failure with either reduced or preserved ejection fraction.
  • Nulibry (fosdenopterin) is approved to treat molybdenum cofactor deficiency, a rare genetic disorder.
  • Amondys 45 (casimersen) is approved to treat Duchenne muscular dystrophy.
  • Azstarys (serdexmethylphenidate/dexmethylphenidate) is approved to treat attention deficit hyperactivity disorder.
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Pharmacy Briefing: February 2021

Pharmacy Briefing is a monthly summary of select U.S. Food and Drug Administration (FDA) approvals and launches, treatment guidelines and research updates, and other newsworthy events that have the potential to impact commercial drug utilization or costs.

Highlights
  • Consolidated Appropriations Act signed into law
  • CMS Office of the Actuary releases 2019 National Health Expenditures
  • Cabenuva (cabotegravir/rilpivirine) is approved as a once-monthly injection for the treatment of HIV.
  • FDA extends review period for investigational Alzheimer’s drug aducanumab
FDA Approvals and Launches
  • Cabenuva (cabotegravir/rilpivirine) is approved as a once-monthly injection for the treatment of HIV.
  • Vocabria (cabotegravir) is approved as one component of a precursor to HIV treatment with Cabenuva (cabotegravir/rilpivirine).
  • Generic version of Glucagon Emergency Kit for Low Blood Sugar is approved to treat cases of severe hypoglycemia in diabetics.
  • Lupkynis (voclosporin) is approved for the treatment of lupus nephritis.
  • Verquvo (vericiguat) is approved for the treatment of heart failure.
News

Consolidated Appropriations Act signed into law

  • The act includes a wide range of provisions regarding COVID-19, medical billing, and pricing transparency, among others.
  • Plans will be required to submit specified pharmacy claims metrics to the federal government on an annual basis.
    • This data collection provision will be used by the government to produce drug pricing trend reports.

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CMS Office of the Actuary releases 2019 National Health Expenditures

  • Retail prescription drug spending grew 5.7% in 2019 compared to 3.8% in 2018.
  • The increased growth rate was driven by an increase in utilization rather than price; retail drug prices declined by 0.4%.

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FDA extends review period for investigational Alzheimer’s drug aducanumab

  • The new action date was extended from March 7 to June 7 to allow for additional review of clinical data.

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Senate Finance Committee releases investigative report on insulin prices

  • The report describes how the relationship among list prices, rebates, and formulary placement has led to increased prices for plan sponsors and consumers.
  • Report authors found that manufacturers also employed “shadow pricing,” a tactic that the report describes as “price increases on related brands of aging products from competing companies that often seem to move in synchronized fashion.”

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Department of Health and Human Services funds report comparing drug prices in the United States with those found internationally

  • After adjusting prices to account for rebates, the authors estimated that U.S. prices were 90% higher than prices found in other countries.

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Maryland State Senate rejects governor’s veto of prescription drug affordability board

  • The drug affordability board was created to help the state create regulations that would attempt to make prescription drugs more affordable by using strategies such as setting payment limits for government payers.

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Consulting firm McKinsey reaches $573 million settlement regarding its role in opioid crisis

  • The firm worked closely with Purdue Pharma, the manufacturer of Oxycontin (oxycodone) extended-release tablets.

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Companies pledge to pay employees for getting the COVID-19 vaccine

  • Companies such as Trader Joe’s, Aldi, and Dollar General will pay employees extra hourly wages as an incentive to get vaccinated but will not make the vaccine mandatory.

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Entrepreneur Mark Cuban launches generic drug company

  • The company’s first drug is antiparasitic drug albendazole but plans to offer over 100 additional drugs by the end of 2021.

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Clinical Trials

Skyrizi (risankizumab) outperforms placebo in phase 3 psoriatic arthritis trial

  • The auto-immune drug is currently only indicated for the treatment of plaque psoriasis.
  • Skyrizi (risankizumab) is considered a successor to Humira (adalimumab) and is currently being studied for the treatment of many overlapping indications.

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Pharmacy Briefing: January 2021

Pharmacy Briefing is a monthly summary of select U.S. Food and Drug Administration (FDA) approvals and launches, treatment guidelines and research updates, and other newsworthy events that have the potential to impact commercial drug utilization or costs.

Highlights

  • The U.S. Supreme Court upholds Arkansas Act 900 regulating pharmacy benefit manager (PBM) practices
  • Drug manufacturers implement annual price increases
  • Highly publicized joint venture Haven Healthcare disbands
  • CVS Health nationwide survey describes factors that may affect COVID-19 vaccine adoption

FDA Approvals and Launches

  • Ebanga (ansuvimab-zykl) is approved to treat the ebolavirus.
  • Imcivree  (setmelanotide) is approved for weight management in three rare genetic disorders.
  • Klisyri (tirbanibulin) is approved to treat actinic keratosis.
  • Gemtesa (vibegron) is approved to treat symptoms of an overactive bladder.

News

The U.S. Supreme Court upholds Arkansas Act 900 regulating PBM practices

  • The act mainly regulates PBM reimbursement to pharmacies, ensuring rates higher than the pharmacies’ acquisition costs.
  • The ruling may encourage other states to pass similar laws regulating PBM practices.

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Drug manufacturers implement annual price increases

  • List prices, which don’t reflect net prices paid after rebates, increased by an average of 3.3%.

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Highly publicized joint venture Haven Healthcare disbands

  • In 2018, Amazon, Berkshire Hathaway, and JPMorgan Chase founded Haven Healthcare with a goal of addressing issues in the employer healthcare market.

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CVS Health nationwide survey describes factors that may affect COVID-19 vaccine adoption

  • 28% of people surveyed were interested in receiving a vaccine as soon as possible whereas 17% did not plan to receive the vaccine at all.

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Employers consider whether to mandate COVID-19 vaccinations

  • Employers may consider public safety, the benefits of a safer work environment, and the concerns of those who worry about the safety of the vaccine before exercising the legal right to mandate vaccination.

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Centene acquires Magellan Health and specialty pharmacy PANTHERx

  • Centene will acquire 5.5 million members on government-sponsored plans, 2 million PBM members, and 16 million medical pharmacy members
  • PANTHERx specializes in providing care to patients with rare conditions and will work under the umbrella of Centene’s Evolve Pharmacy Solutions program.

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Federal Trade Commission (FTC) issues report describing Hatch-Waxman patent settlements

  • The report describes patent settlements occurring in 2017 between brand and generic manufacturers.
    • The total amount of final settlements remained close to the record high set in 2016.
    • The number of reverse-payment agreements, otherwise known as “pay-for-delay” agreements, remains low compared to previous years.

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Amgen releases 2020 Biosimilars Trends Report

  • The report describes trends among the 28 FDA-approved and 18 market-launched biosimilar products.
    • The report includes comparisons between biosimilar and reference product prices, market share trends, and class-specific trends.

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Elixir drug pipeline report highlights six developments to watch in 2021

  • Developments include increases in the orphan drug and gene therapy markets, an investigational type 1 diabetes drug, and commentary on the COVID-19 vaccine.

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Clinical Trials

Long-acting injectable HIV drug combination produces positive results in phase 3b study

  • The combination of cabotegravir and rilpivirine given intramuscularly every eight weeks was found to be non-inferior to dosing given every four weeks.
    • This investigational treatment has the potential to increase adherence over standard treatments that must be dosed daily.

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Will Amazon Pharmacy transform the pharmacy industry?

Amazon Pharmacy, the tech giant’s latest venture into healthcare, launched a mail-order pharmacy in November 2020. The venture provides mail prescription delivery for all patients, as well as the additional benefits of two-day prescription delivery and discounted medication prices for Amazon Prime members through the Prime Rx program. Patients can have providers send prescriptions directly to Amazon or Amazon can contact the provider on the patient’s behalf. Amazon Pharmacy complements Amazon PillPack, which sorts medications into small, individual packages based on the date and time of day they are to be taken. 

Effectively, Amazon is joining the existing pharmacy supply chain. Amazon Pharmacy works with pharmacy benefit managers to ensure its mail-order pharmacy service is included in pharmacy networks when prescriptions are filled with insurance. When insurance is not used, Amazon offers Prime members discounted pricing through its mail-order pharmacy or at participating retail locations. 

In this paper, Milliman professionals discuss whether Amazon Pharmacy will disrupt, conform, or lay the groundwork for future transformation in the pharmacy industry. 

Pharmacy Briefing: December 2020

Pharmacy Briefing is a monthly summary of select U.S. Food and Drug Administration (FDA) approvals and launches, treatment guidelines and research updates, and other newsworthy events that have the potential to impact commercial drug utilization or costs.

Highlights
  • FDA grants Emergency Use Authorization for Pfizer/BioNTech COVID-19 vaccine
  • Amazon enters retail pharmacy sector, launches Amazon Pharmacy
  • United Kingdom approves Pfizer/BioNTech COVID-19 vaccine
  • Kaiser Family Foundation report describes COVID-19’s effect on national health spending and utilization
FDA Approvals and Launches
  • Sesquient (fosphenytoin injection) is approved to treat status epilepticus.
  • Flu treatment Xofluza (baloxavir marboxil) receives additional indication for use in flu prevention (post-exposure prophylaxis).
  • Oxlumo (lumasiran) is approved to treat primary hyperoxaluria type 1, a rare genetic disorder.
  • Orladeyo (berotralstat) is approved to treat hereditary angioedema.
News

FDA grants Emergency Use Authorization for Pfizer/BioNTech COVID-19 vaccine

  • The decision follows a recommendation from the agency’s Vaccines and Related Biological Products Advisory Committee.

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Amazon enters retail pharmacy sector, launches Amazon Pharmacy

  • The online pharmacy can service patients with or without insurance and provides free two-day delivery for Prime members.
  • The service currently comes with some limitations.
    • No option of 90-day fills or automatic refills.
    • Examples of unavailable products include diabetic testing supplies, schedule II-controlled substances, specialty medications, and liquid suspensions.

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Kaiser Family Foundation report describes COVID-19’s effect on national health spending and utilization

  • As of the third quarter (Q3) 2020, authors found a decrease of 2.4% in non-pharmaceutical health spending relative to the same period in 2019.
  • As of October 2020, pharmaceutical spending increased 6.3%.

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HHS and FDA under legal pressure against drug importation final rule

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FDA advisory committee rejects endorsement of investigational Alzheimer’s drug aducanumab

  • The drug, if approved, would be the first Alzheimer’s treatment approved in over 17 years.

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U.S. Department of Health and Human Services (HHS) Special Fraud Alert warns against prescription kickback loophole

  • The alert highlights the practice of drug manufacturers awarding high-prescribing healthcare providers with speaking deals worth potentially hundreds of thousands of dollars.
  • HHS cautions that this practice violates federal anti-kickback statutes.

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OptumRx publishes Q4 Drug Pipeline Insights Report

  • The report highlights five drugs with FDA decisions in the near future, including novel cholesterol drug inclisiran.

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United Healthcare delays implementation of Accumulator Adjustment – Medical Benefit program

  • The program faced public backlash from several groups including the American Academy of Family Physicians and American Medical Association.

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Clinical Trials and Research

Pfizer/BioNTech and Moderna produce positive COVID-19 vaccine trial results

  • As a result of the clinical trial data, the manufacturers of the two vaccines have submitted requests for Emergency Use Authorization to the FDA.
  • The vaccines require two separate doses to achieve full efficacy.

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United Kingdom becomes first country to approve a COVID-19 vaccine

  • The country approved the vaccine developed by manufacturers Pfizer and BioNTech.
  • As of December 9, Bahrain and Canada have also approved the same product.

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Investigational long-acting HIV drug, cabotegravir, achieves endpoints in superiority trial

  • The injectable drug is dosed once every two months and was found to be more effective than daily Truvada (emtricitabine/tenofovir disoproxil fumarate) at preventing HIV transmission in women.

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