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.

News

Evernorth publishes 2020 Drug Trend Report

  • The group, which includes PBM Express Scripts, reported a 4.0% overall trend.
    • This trend was comprised of a 3.1% utilization increase and a 0.9% unit cost increase.
  • Drugs used to treat specialty conditions saw 2% utilization while accounting for almost 51% of total pharmacy spend.

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Fierce Pharma report highlights top 10 drugs losing patent exclusivity in 2021

  • The report includes drugs such as Lucentis (ranibizumab), Bystolic (nebivolol), and Vascepa (icosapent ethyl).

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Fierce Pharma summarizes the year’s top 10 most anticipated drug launches

  • This year’s list includes investigational Alzheimer’s drug aducanumab and cholesterol drug inclisiran.

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Sanofi publishes 2021 Pricing Principles Report

  • The manufacturer describes its process for pricing new-to-market drugs and changing prices for existing drugs, with guidelines to limit increases to no more than the projected National Health Expenditure growth rate.
  • Sanofi reported that it lowered the list price of enoxaparin by 71% in October 2020 and that the net cost (i.e., cost after discounts, rebates, and fees) of its insulins has decreased 53% since 2012.

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CMS updates Medicare payment rates for COVID-19 vaccine administration

  • For vaccines administered on or after March 15, the new payment rate is $40 per dose of vaccine (geographically adjusted).
  • For vaccines administered before March 15, the payment rate for a single-dose vaccine or for the final dose in a series is $28.39. For a vaccine requiring a series of two or more doses, the payment rate is $16.94 for the initial dose(s) in the series and $28.39 for the final dose in the series (also geographically adjusted).

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Becker’s Hospital Review highlights several recent industry lawsuits

  • Examples of alleged issues in recent lawsuits include antitrust settlements, fraudulent billing, and misrepresented PBM expenses costs to Medicaid plans.

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Texas Senate approves bill capping monthly insulin copays at $50

  • The state joins 15 others with approved insulin copay cap legislation.

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Congress members pressure Federal Trade Commission to investigate insulin industry

  • In a letter address to the FTC Chairwoman, Congress members request an investigation into allegations of collusion among three pharmaceutical manufacturers.

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Pew Charitable Trusts describes inappropriate utilization of antibiotics during the pandemic

  • 52% of COVID-19 hospital admissions captured in the study resulted in at least one antibiotic prescription.
  • The authors assert that antibiotic resistance is a growing threat to public health, in part, due to the lack of antibiotics in the drug development pipeline.

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JAMA study examines the reasons and financial effects of brand drug dispensing in the Medicare Part D program

  • The study found that 30.4% of branded dispensing of multisource drugs in 2017 was due to prescriber or patient request.
    • These claims represent a potential $1.67 billion and $270 million in savings for the program and patients, respectively.
  • The authors suggest that policies targeted toward prescriber behavior have the greatest potential to generate savings.

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Clinical Trials

Tirzepatide produces superior glycemic control and weight loss in head-to-head phase 3 trial

  • The investigational drug was compared to semaglutide, a currently available diabetes drug marketed under the brand name Ozempic.

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