Datapoint

Datapoint: Sarclisa to Compete with Darzalex in Multiple Myeloma

April 6, 2021

The FDA last week approved Sanofi’s Sarclisa (in tandem with Amgen’s Kyprolis and dexamethasone) for the treatment of relapsed or refractory multiple myeloma in patients who have had at least one prior treatment. This will put Sarclisa in direct competition with Amgen’s Darzalex, which scored the same indication in August 2020. For the treatment of multiple myeloma, Darzalex currently holds preferred formulary placement for 7% of covered lives, growing to 17% with utilization management restrictions applied.

The FDA last week approved Sanofi’s Sarclisa (in tandem with Amgen’s Kyprolis and dexamethasone) for the treatment of relapsed or refractory multiple myeloma in patients who have had at least one prior treatment. This will put Sarclisa in direct competition with Johnson & Johnson’s Darzalex, which scored the same indication in August 2020. For the treatment of multiple myeloma, Darzalex currently holds preferred formulary placement for 7% of covered lives, growing to 17% with utilization management restrictions applied.

SOURCE: MMIT Analytics, as of 4/5/21

Datapoint: Medicaid Enrollment Grows More Than 10% Year-Over-Year

April 5, 2021

From March 2020 to March 2021, the total U.S. Medicaid population (including managed care plans and traditional fee-for-service coverage) grew 11.1% to 81.9 million lives, according to the latest update to AIS’s Directory of Health Plans. This growth is largely a result of the COVID-19 pandemic, though one state, Idaho, implemented Medicaid expansion in January 2020.

From March 2020 to March 2021, the total U.S. Medicaid population (including managed care plans and traditional fee-for-service coverage) grew 11.1% to 81.9 million lives, according to the latest update to AIS’s Directory of Health Plans. This growth is largely a result of the COVID-19 pandemic, though one state, Idaho, implemented Medicaid expansion in January 2020.

Source: AIS’s Directory of Health Plans

Datapoint: Blues Plans Enroll Half of Group Risk Market

April 1, 2021

Nearly half (47.3%) of the national group commercial risk insurance market is enrolled in a Blue Cross and Blue Shield affiliate plan. Of the 26.2 million group risk lives enrolled in a Blues plan, 20.5% are Anthem, Inc. members.

Nearly half (47.3%) of the national group commercial risk insurance market is enrolled in a Blue Cross and Blue Shield affiliate plan. Of the 26.2 million group risk lives enrolled in a Blues plan, 20.5% are Anthem, Inc. members.

Source: AIS’s Directory of Health Plans

Datapoint: FDA Approves Abecma for Multiple Myeloma

March 31, 2021

The FDA last week approved Bristol Myers Squibb’s and bluebird bio’s Abecma for the treatment of multiple myeloma in patients who have not responded to at least four previous rounds of treatment. Abecma is the first CAR-T cell therapy approved for multiple myeloma. This is the second CAR-T therapy for Bristol Myers, following Breyanzi’s lymphoma nod in February. Early data shows Breyanzi is currently covered for 9% of all insured lives, with utilization management restrictions applied.

The FDA last week approved Bristol Myers Squibb’s and bluebird bio’s Abecma for the treatment of multiple myeloma in patients who have not responded to at least four previous rounds of treatment. Abecma is the first CAR-T cell therapy approved for multiple myeloma. This is the second CAR-T therapy for Bristol Myers, following Breyanzi’s lymphoma nod in February. Early data shows Breyanzi is currently covered for 9% of all insured lives, with utilization management restrictions applied.

SOURCE: MMIT Analytics, as of 3/29/21

Datapoint: Anthem to Acquire Senior Home Management Company

March 30, 2021

Anthem, Inc. last week unveiled plans to acquire myNEXUS, Inc., “a comprehensive home-based nursing management company for payors,” the insurer said in a press release. The myNEXUS platform is a provider-facing service, and allows for streamlined authorization of in-home nursing care. Anthem said myNEXUS currently serves 1.7 million Medicare Advantage (MA) members across 20 states. Anthem is currently the fifth-largest MA payer in the U.S., with 1,493,268 enrollees, a 16% increase from last year.

Anthem, Inc. last week unveiled plans to acquire myNEXUS, Inc., “a comprehensive home-based nursing management company for payors,” the insurer said in a press release. The myNEXUS platform is a provider-facing service, and allows for streamlined authorization of in-home nursing care. Anthem said myNEXUS currently serves 1.7 million Medicare Advantage (MA) members across 20 states. Anthem is currently the fifth-largest MA payer in the U.S., with 1,493,268 enrollees, a 16% increase from last year.

Source: AIS’s Directory of Health Plans

Datapoint: Keytruda Scores First-Line Esophageal Cancer Nod

March 29, 2021

The FDA last week approved Merck & Co.’s Keytruda for the treatment of newly diagnosed esophageal or gastroesophageal junction carcinoma in tandem with chemotherapy. Keytruda is the first PD-1/L1 agent to be approved as a first-line therapy for this type of cancer. The drug was approved as a third-line treatment for gastric or gastroesophageal junction cancer in 2017, an indication where it holds preferred formulary placement for 6% of covered lives under the pharmacy benefit.

The FDA last week approved Merck & Co.’s Keytruda for the treatment of newly diagnosed esophageal or gastroesophageal junction carcinoma in tandem with chemotherapy. Keytruda is the first PD-1/L1 agent to be approved as a first-line therapy for this type of cancer. The drug was approved as a third-line treatment for gastric or gastroesophageal junction cancer in 2017, an indication where it holds preferred formulary placement for 6% of covered lives under the pharmacy benefit.

SOURCE: MMIT Analytics, as of 3/24/21