Member: RADAR on Specialty Pharmacy

Opinions Vary on Usefulness of ICER Report on Drug Price Hikes

November 1, 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 last month, 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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Questions Exist Around Beovu’s Uptake in Full Anti-VEGF Market

With Chart: Payers are likely to manage brolucizumab and Eylea at parity and unlikely to not cover the drug

November 1, 2019

Last month, the FDA approved Beovu (brolucizumab-dbll) from Novartis Pharmaceuticals Corp. for the treatment of neovascular (wet) age-related macular degeneration (AMD) (see brief, p. 8). The intravitreal injection will compete in a fairly crowded anti-vascular endothelial growth factor (anti-VEGF) market that is led by Eylea (aflibercept) from Regeneron Pharmaceuticals, Inc.

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Novel New Drugs Offer Hope to Patients, Challenges to Payers

November 1, 2019

As innovative new therapies — many of them expensive one-time treatments — come onto the U.S. market, they are sparking a discussion around pharma reimbursement. With the drug pipeline full of many novel treatments, questions exist around whether traditional payment systems are appropriate for the products, and many experts maintain that new approaches are needed.

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Study: NSCLC EGFR-i May Be Fit for Value-Based Contracts

November 1, 2019

A recently unveiled study shows that one first-line therapy for non-small cell lung cancer (NSCLC) with an epidermal growth factor receptor (EGFR) mutation is substantially more costly than four other competitor therapies. Payers may wish to consider implementing management strategies to help rein in costs, according to the study from Prime Therapeutics LLC.

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CMS Sticks With Its Disputed Definition of Home Infusion Day

November 1, 2019

Through a recent final rule on home infusion therapy requirements, CMS continues to brush aside industry feedback about how the agency interprets the service. And the National Home Infusion Association (NHIA) remains steadfast in pushing back against the decision, contending that home infusion providers are not being adequately reimbursed, which in turn puts Medicare beneficiary access to home infusion therapy at risk.

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