Pharmacy Briefing: May 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.


  • CVS Health publishes 2020 Drug Trend Report
  • Janssen publishes 2020 U.S. Transparency Report
  • American Journal of Health-System Pharmacy (AJHP) trend report describes changes in pharmaceutical expenditures in 2020
  • Oklahoma and Kentucky limit use of copay accumulator policies

FDA Approvals and Launches

  • Praluent (alirocumab) receives additional indication as add-on therapy to treat homozygous familial hypercholesterolemia.
  • Myrbetriq (mirabegron) receives additional indication to treat a pediatric bladder dysfunction.
  • Qelbree (viloxazine) is approved to treat ADHD in patients ages 6 to 17.
  • Farxiga (dapagliflozin) receives additional indication to reduce risk of kidney function decline, kidney failure, cardiovascular death, and hospitalization for heart failure in adult patients with chronic kidney disease


CVS Health publishes 2020 Drug Trend Report

  • The company reported a 2.9% overall drug trend, a 1.7% increase in utilization, and a 1.2% increase in prices.
  • 90% of spend was driven by five therapeutic categories: autoimmune, oncology, cystic fibrosis, atopic dermatitis, and HIV.

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Janssen publishes 2020 U.S. Transparency Report

  • The manufacturer reports a 5.7% decrease in net prices for its products in 2020 and $29.4 billion paid in the form of rebates, discounts, and fees.

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AJHP trend report describes changes in pharmaceutical expenditures in 2020

  • Overall pharmaceutical expenditures grew 4.9% in 2020, driven mainly by increases in utilization rather than price changes.

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Oklahoma and Kentucky limit use of copay accumulator policies

  • The Kentucky legislation limits the use of copay accumulator policies to instances where a generic alternative is available.
  • The Oklahoma legislation prohibits the practice entirely.

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Anthem BCBS “white bagging” policy gets pushback from providers

  • “White bagging” refers to insurers mandating that providers purchase specialty drugs through the insurer’s own specialty drug network rather than through other means such as through the 340b discount program.
  • Some providers assert that this practice limits the flexibility of on-site preparations and raises the potential for negative clinical outcomes.
  • Insurers introducing these policies claim that the practice can help lower overall out-of-pocket costs of some specialty medications.

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Kentucky becomes latest state to cap out-of-pocket insulin costs

  • The state passed a bill limiting a 30-day cost of insulin to $30 for those enrolled in state-regulated health plans, ACA plans, group plans, and state employees.

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American Journal of Managed Care article highlights practice of “non-medical switching”

  • According to the article, Cigna is directly reaching out to patients and providers to offer patients a $500 incentive for switching from Cosentyx (secukinumab) to Taltz (ixekizumab).
    • While both drugs are list priced similarly, manufacturer rebate agreements may incentivize the use of one product over another.

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Clinical Trials

Investigational psoriasis drug deucravacitinib demonstrates superiority over Otezla (apremilast) in phase 3 trials

  • The first-in-class drug demonstrated superior skin clearance and was well-tolerated in the 52 week trial.

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