Patient adherence to medication is one of the top concerns in the health care system today. And when it comes to expensive specialty drugs that often treat potentially deadly conditions, adherence is vital to not only patient outcomes but also cost-effective care. Indeed, according to the pharmacy and medical directors at 102 health plans representing more than 106 million covered lives who were queried for the ninth edition of the EMD Serono Specialty Digest, adherence measurement and... Read more

On Monday the Supreme Court is scheduled to hear oral arguments in FTC v. Actavis. At stake is whether so-called “pay-for-delay” or reverse-payment agreements between brand and generic drug manufacturers are lawful. Through these deals, brand drug manufacturers pay would-be generic drug competitors that are challenging brand companies’ patents to delay their products’ entry onto the market. Many of these agreements also include the concession from brand manufacturers that they will not market... Read more

After a ton of pushback, including a lawsuit, against a planned change to how Anthem Blue Cross members get their specialty drugs, the insurer recently delayed the program’s implementation. The change would have meant that members had to receive these drugs through mail order from specialty pharmacy CuraScript, rather than through retail pharmacies. If a member filled a prescription for one of the specialty drugs included on a list that was sent to members along with a letter explaining the... Read more

Much of the focus on specialty drugs nowadays is on how many oral therapies either have been approved or are in the pipeline. And with good reason — these drugs present a whole new set of complications, particularly in the area of patient adherence, than injectable and infusible therapies, which had been the norm in terms of treatments up until the past five years or so for many of these conditions. But payers shouldn’t ignore infusibles since these drugs —which are estimated to represent... Read more

The FDA has been particularly busy with the specialty drug pipeline the last couple of years. Consequently, payers have been spending a good amount of time analyzing these drugs in order to determine their benefit design strategies. In 2011, two new hepatitis C oral drugs seemed to get the bulk of the chatter surrounding the specialty pharma pipeline. In addition, the FDA approved a drug for lupus — the first OK’d for that condition in more than 50 years — as well as two oncology drugs that it... Read more

Yesterday The Kroger Co. said that it had agreed to purchase specialty pharmacy Axium Pharmacy Holdings, Inc. Wait — what? Kroger, which owns such stores as Fry’s, King Soopers, Fred Meyer and Smith’s, is the largest supermarket operator in the U.S. But it also has almost 2,000 pharmacy locations and 91 Little Clinic locations. “Very few [non-drugstore retailers] have moved aggressively into specialty,” notes Adam Fein on his Drug Channels blog, citing Schnucks as a “notable exception.” A... Read more

By now I’m assuming most people have heard of the outbreak of fungal meningitis allegedly caused by a potentially contaminated steroid used for spinal injections. As of Thursday afternoon, the CDC was reporting 257 cases across 16 states, with 20 deaths. And the agency says it is investigating other infections that supposedly are tied to additional products from the same pharmacy. But as an AP article noted, this isn’t the first time that compounded medicines have been tied to injuries and... Read more

I moderated a webinar Sept. 20 on outcomes-based contracts, and one of the speakers asked a question that I found very interesting. Michael Jacobs, vice president of national accounts at Truveris, was speaking about the Health Value Continuum, as described by the Center for Health Value Innovation, which starts with a reactive approach to health, then pro-active, integrated, aligned and sustainable. An overall community culture of health is the ultimate goal. Jacobs spoke about needing to move... Read more

Genzyme is pulling its drug Campath, which has FDA approval for the treatment of B cell chronic lymphocytic leukemia (CLL), from the U.S. and European markets. The reason? It’s trying to prevent off-label use of the drug in multiple sclerosis and pave the way for a renamed version of the same drug, known as Lemtrada, to enter the MS space. But Campath isn’t disappearing for good. In fact, as of Sept. 4, once a health care provider has “document[ed] and compl[ied] with certain requirements”... Read more