Pharmacy Briefing: September 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

  • Teladoc and Livongo merge to create $37 billion dollar healthcare enterprise
  • President Trump signs executive order for essential drugs and medical supplies
  • Express Scripts makes changes to 2021 national formulary
  • UnitedHealthcare to stop covering Descovy (emtricitabine/tenofovir alafenamide) starting September 1

FDA Approvals and Launches

  • Spravato (esketamine) receives new indication to treat certain patients with major depressive disorder.
  • Evrysdi (risdiplam) is approved as the first oral therapy to treat spinal muscular atrophy.
  • Enspryng (satralizumab) is approved to treat neuromyelitis optica spectrum disorder (NMOSD), a rare autoimmune disease.
  • Generic version of Tecfidera (dimethyl fumarate), used to treat multiple sclerosis, launches.
  • Kesimpta (ofatumumab) is approved to treat multiple sclerosis.
  • Winlevi (clascoterone) cream is approved to treat acne vulgaris.
  • FDA removes amputation risk boxed warning from Invokana (canagliflozin) labeling.

News

Teladoc and Livongo, providers of remote health services, merge to create $37 billion dollar enterprise

  • Teladoc specializes in providing telehealth appointments while Livongo provides care management for patients with chronic conditions.

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President Trump signs executive order for essential drugs and medical supplies

  • The executive order mandates that purchases of essential drugs and medical supplies must come from American manufacturing plants.
  • There is no currently proposed list detailing which products are considered essential.

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Express Scripts makes changes to 2021 national formulary

  • Changes include the exclusion of Cosentyx (secukinumab), Calquence (acalabrutinib), and Praluent (alirocumab).

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UnitedHealthcare to stop covering Descovy (emtricitabine/tenofovir alafenamide) starting September 1

  • Generic Truvada (emtricitabine/tenofovir disoproxil fumarate) will be available for no out-of-pocket cost and become the preferred option for patients once it is available at the end of September.

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Milliman publishes PBM Best Practices Series

  • In a series of white papers, Milliman details best practices that plan sponsors should follow when working with pharmacy benefit managers (PBMs).

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OptumRx highlights the high cost of certain prenatal vitamins in first Drug Pricing Spotlight Report

  • High-cost prenatal vitamins result in significant, unnecessary out-of-pocket and plan costs because cheaper, effective alternatives exist.

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GoodRx files initial public offering

  • The company tracks prescription drug prices across retail pharmacies and provides consumers discounts on cash prices for prescriptions.

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AbbVie pays $24 million to settle lawsuit over alleged kickback scheme

  • The lawsuit claims that the manufacturer paid kickbacks to physicians and nurses to boost sales of Humira (adalimumab).

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Drug Channels examines the list price versus net price trends

  • Discounts from list prices and rebates have been increasing in recent years.
  • List prices are poor measures for drug pricing because they don’t reflect actual costs experienced by plan sponsors.
    • As an example, over the past five years, the Humalog (insulin lispro) list price has increased by 27% despite its net price decreasing by 10%.

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Drug Channels examines COVID-19 drug trends

  • The article predicts that, despite the pandemic, mail-order pharmacy will only gain a slight boost in utilization.
  • The number of new prescriptions has decreased significantly due to a decline in outpatient care.

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New England Journal of Medicine study finds that capping out-of-pocket specialty drug costs can reduce spending for patients without significant increases in overall health plan spending

  • The study, funded by the Robert Wood Johnson Foundation, reflected ideas from legislation passed in Delaware, Louisiana, and Maryland, which capped out-of-pocket payments for specialty drugs at $150 per prescription.

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CDC study confirms the effect of COVID-19 on the incidence of mental health conditions

  • Increased incidence of mental health conditions, substance use, and suicidal ideation was observed in the second quarter (Q2) of 2020 compared to Q2 2019.
    • This trend was disproportionately high among young adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers.

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