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BioScrip, Option Care Will Join Forces Within Infusion Market

April 1, 2019

Two of the country’s largest independent infusion services providers recently unveiled that they have entered into a merger agreement. After coming together, BioScrip, Inc. and Option Care Enterprises, Inc. would be the No. 2 home/alternate site infusion provider in the United States, boosting their ability to get both manufacturer and payer contracts.

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Virginia Passes Law Barring Accumulators; Programs’ Use Rises

with Chart: Payers that cover nearly 60% of lives have copay accumulator programs in effect and will not make changes in the next year

April 1, 2019

Payers are continuing to implement copay accumulators and copay maximizers in an effort to counter copay assistance from pharmaceutical manufacturers, according to a recent survey. Research shows these programs target specialty drugs almost exclusively, so while they may provide short-term benefits to payers, in the long run they may result in higher downstream costs. As accumulators and maximizers come under fire from patient-advocacy groups and other stakeholders for their potential impact on patient outcomes, a new state law essentially banning these programs, as well as potential legal challenges, may pose difficulties for payers implementing them.

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Drugmakers Are Trying Array of Tactics to Counter Copay Accumulator Programs

April 1, 2019

As more health plans are implementing copay accumulator programs, manufacturers are struggling to find ways to counter them. In addition to the loss of patients who stop taking their drugs once they’re on the hook for larger out-of-pocket payments, drugmakers are taking another financial hit by having to increase their funding of income-based patient-assistance programs to help people hitting the annual limits on how much copay assistance they can receive due to accumulators and then shifting to patient-assistance programs. So what can companies do?

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Studies Examine Current, Future Costs for SMA, CF Therapies

April 1, 2019

Prime Therapeutics LLC unveiled findings from a handful of studies at the Academy of Managed Care Pharmacy Managed Care & Specialty Pharmacy Annual Meeting, held March 25 to 28 in San Diego. One examined the use and cost of Ionis Pharmaceuticals, Inc.’s Spinraza (nusinersen) for the treatment of spinal muscular atrophy (SMA), as well as forecast costs for a gene therapy anticipated to gain FDA approval this year with a one-time cost of millions of dollars. A second study researched another costly condition, cystic fibrosis, which may double in terms of spending on drugs this year.

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Studies Analyze Factor VIIIs, Split-Fills for Oral Oncolytics

April 1, 2019

AllianceRx Walgreens Prime recently released a pair of research studies that offer insight into a couple of areas of payer concerns with specialty therapies. The first study looked into results of a split-fill program for oral oncolytics and showed the opportunity for cost savings through such a program. The second compared extended half-life and standard half-life factor products for people with hemophilia A and showed that while EHL products reduced patients’ bleed rates and number of infusions, those benefits came at a higher cost than did SHL products.

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