Member: RADAR on Specialty Pharmacy

Multiple Myeloma Continues to Pose Management Challenges

June 9, 2021

Multiple myeloma, an incurable blood disease that starts in the bone marrow and can be a relatively rare cancer, has an array of products available to treat it, and new agents — including the first gene therapy for the disease — continue to gain FDA approval. However, as the therapies are different types of drugs, management of the space can be challenging.

To access this post, you must purchase a subscription plan. Click Here to purchase.

Already a member? Click Here to login.

Prime: MS Spend Was Steady as Generics Helped Offset Costs

June 1, 2021

More than 20 multiple sclerosis (MS) disease-modifying drugs (DMDs) currently are available in the U.S. But even with all the competition, prices for most of the agents are around $80,000 per year. Following updated professional treatment guidelines and the FDA approval of new therapies, including generics, Prime Therapeutics LLC recently conducted a study to determine spend and use of the agents over a two-year period. Spending for the class remained fairly steady, as generic use helped offset some costs. Payers should encourage use of these products to help contain their spend on this class, maintains a source from the PBM.

To access this post, you must purchase a subscription plan. Click Here to purchase.

Already a member? Click Here to login.

Magellan Rx Report: Medical Drug Spend Continues to Rise

With Chart: Biosimilar step therapy criteria-Biosimilar products preferred over

June 1, 2021

From 2009 to 2019, commercial per-member per-month costs have almost doubled, from $17.28 to $32.73, an increase of 89%, according to the latest Medical Pharmacy Trend Report from Magellan Rx Management. The report also found that the cost of Remicade (infliximab), the top commercial drug, has grown two-and-a-half times during that same period.

To access this post, you must purchase a subscription plan. Click Here to purchase.

Already a member? Click Here to login.

Blues Plan Launches Value-Based Kidney Care Program

June 1, 2021

Blue Cross and Blue Shield of Minnesota recently launched a new value-based agreement with VillageHealth focused on certain members with chronic kidney disease (CKD) or end-stage renal disease (ESRD). By working with VillageHealth, a DaVita Inc. subsidiary, the Blues plan hopes to improve member outcomes and reduce their total cost of care.

To access this post, you must purchase a subscription plan. Click Here to purchase.

Already a member? Click Here to login.

Most Payers Expect to Manage New MS Drug Ponvory to Label

With Chart: About 60% of neurologists are likely to prescribe ponesimod

June 1, 2021

Although there are more than 20 FDA-approved disease-modifying therapies (DMTs) for multiple sclerosis (MS), companies continue to bring new products to market. Zitter Insights found that the majority of payers expect to manage the newest entrant, the Janssen Pharmaceutical Companies of Johnson & Johnson’s Ponvory (ponesimod), to label.

To access this post, you must purchase a subscription plan. Click Here to purchase.

Already a member? Click Here to login.