November

New Acute Migraine Drugs Likely Won’t Topple Triptans

November 26, 2019

New oral medications for acute migraine — one pending launch and two more that could be approved in the coming months — likely won’t shake up formulary coverage for a condition that’s largely treated by generic triptan medications, pharmacy benefit experts say.

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As Multiple Sclerosis Treatment Options Expand, So Do Costs

with Chart: Current Market Access to Multiple Sclerosis Medications

November 26, 2019

FDA approval of Biogen Inc. and Alkermes’ Vumerity (diroximel fumarate) on Oct. 30 made it the third oral disease-modifying therapy (DMT) cleared this year to treat relapsing forms of multiple sclerosis (MS), the most common type. Biogen will sell the follow-on to its MS franchise leader Tecfidera (dimethyl fumarate) at an annual wholesale acquisition cost (WAC) of $88,000 before rebates — the lowest of any oral DMT in the U.S., the company says. Still, with prices rising yearly at rates 5 to 7 times higher than prescription drug inflation, according to a study published in Neurology, DMTs remain one of the highest-spend drug classes for payers.

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Highmark Advances on OBCs, Touting Symbicort Results

November 26, 2019

Highmark recently said its outcomes-based contract (OBC) with AstraZeneca showed positive results for its commercial members with asthma and chronic obstructive pulmonary disease (COPD) taking Symbicort — to the point where the drug manufacturer didn’t have to pay back a rebate to the insurer. Indeed, Highmark is looking at broadening the scope and is currently in discussions with AstraZeneca about “potential future opportunities” in the respiratory space, “possibly beyond Symbicort,” Highmark’s pharma relations head tells AIS Health.

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Opinions Vary on Usefulness of ICER Report on Drug Price Hikes

November 26, 2019

As the spotlight continues to focus on drug prices and companies’ pricing strategies, an industry watchdog group has published the first of many planned reports on the topics. The Institute for Clinical and Economic Review (ICER) released the inaugural edition of the series recently, offering fodder to critics of the pharmaceutical industry. But others question the findings. Still, the report should give some momentum to the various drug pricing efforts, industry experts tell AIS Health.

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News Briefs

November 26, 2019

✦ Activist investor Starboard Value LP has taken what is apparently a “relatively small stake” in CVS Corp. and held “amicable” talks with management, the Wall Street Journal reports. CVS’s shares “have been on a roller-coaster ride” since its $69 billion acquisition of Aetna Inc. in November 2018, rebounding sharply this fall amid unexpectedly strong financial results, the news outlet notes. But some investors “have privately expressed frustration over rising costs from CVS’s Omnicare nursing-home pharmacy business, the lack of a clear plan for a successor to Chief Executive Larry Merlo and the large size of its 16-member board — a legacy of the Aetna deal,” the WSJ said, noting Starboard “has a record of ushering in change at companies.” Read the WSJ article at https://on.wsj.com/2R3oL0D.

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Twin Transparency Rules: Here’s What Insurers Should Know

November 25, 2019

On Nov. 15, the Trump administration released two rules — one final, one proposed — outlining new price transparency requirements for hospitals and health insurers, which the industry has long warned will impede competitive rate negotiations without actually benefiting patients.

But while legal challenges could delay or even prevent those rules from being implemented, that doesn’t mean health care organizations have nothing to worry about.

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