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Multiple Myeloma Continues to Pose Management Challenges

June 10, 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.

Winston Wong, Pharm.D., president of W-Squared Group, points out that about 20 therapies are available to treat multiple myeloma. As of April, the National Institutes of Health listed more than 200 clinical trials, many for gene therapies, he adds. “Thus, the already crowded and complicated field of treatment options is only going to get more crowded,” he tells AIS Health, a division of MMIT.

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.

Winston Wong, Pharm.D., president of W-Squared Group, points out that about 20 therapies are available to treat multiple myeloma. As of April, the National Institutes of Health listed more than 200 clinical trials, many for gene therapies, he adds. “Thus, the already crowded and complicated field of treatment options is only going to get more crowded,” he tells AIS Health, a division of MMIT.

“The evolution of multiple myeloma treatments reflects our greater understanding of the various pathways that mediate the disease,” he explains. “While induction regimens have remained rather consistent over the years, the majority of the recently approved treatment options are in the maintenance and resistant/relapsing stages of treatment.”

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Prime: MS Spend Was Steady as Generics Helped Offset Costs

June 10, 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.

All of the drugs in the study are approved to treat relapsing forms of MS, the most common disease course. Only one — ocrelizumab — also is approved to treat primary progressive MS.

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.

All of the drugs in the study are approved to treat relapsing forms of MS, the most common disease course. Only one — ocrelizumab — also is approved to treat primary progressive MS.

Prime presented the findings during the Academy of Managed Care Pharmacy Virtual Annual Meeting in April.

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Magellan Rx Report: Medical Drug Spend Continues to Rise

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

June 10, 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.

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.

For the first time, the top five PMPM commercial drugs have changed, with Ocrevus (ocrelizumab) ranked in the No. 3 spot, displacing Avastin (bevacizumab), which fell to the seventh spot. Researchers found that out of 32 surveyed payers, 72% preferred Avastin’s biosimilars over the reference product (see chart below).

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Blues Plan Launches Value-Based Kidney Care Program

June 10, 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.

The Centers for Disease Control and Prevention estimates that more than one in seven adults in the U.S. — or 37 million people — have CKD, but most of them do not realize it. When the kidneys are damaged, this can result in high blood pressure, heart disease, stroke and early death. If the condition is not treated, it can progress to ESRD, which requires a transplant or dialysis.

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.

The Centers for Disease Control and Prevention estimates that more than one in seven adults in the U.S. — or 37 million people — have CKD, but most of them do not realize it. When the kidneys are damaged, this can result in high blood pressure, heart disease, stroke and early death. If the condition is not treated, it can progress to ESRD, which requires a transplant or dialysis.

Program Will Coordinate Members’ Care

The program has a variety of components. VillageHealth and DaVita will collaborate with nephrologists and primary care physicians to coordinate care for plan members into an integrated plan. The program will launch an awareness campaign for primary care providers focused on improving screening for kidney disease, managing early-stage patients and offering appropriate referrals to nephrologists.

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Most Payers Expect to Manage New MS Drug Ponvory to Label

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

June 10, 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.

On March 19, the FDA approved Ponvory to treat adults with relapsing forms of MS, including clinically isolated syndrome, relapsing-remitting disease and active secondary progressive disease. The approval was based in part on the Phase III OPTIMUM study, which showed the product reduced annual relapses by 30.5%, compared with Sanofi’s Aubagio (teriflunomide). It also reduced brain lesions by more than 50%.

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.

On March 19, the FDA approved Ponvory to treat adults with relapsing forms of MS, including clinically isolated syndrome, relapsing-remitting disease and active secondary progressive disease. The approval was based in part on the Phase III OPTIMUM study, which showed the product reduced annual relapses by 30.5%, compared with Sanofi’s Aubagio (teriflunomide). It also reduced brain lesions by more than 50%.

The sphingosine 1-phosphate (S1P) receptor modulator joins other oral agents within that class: Gilenya (fingolimod) and Mayzent (siponimod), both from Novartis Pharmaceuticals Corp., and Bristol Myers Squibb’s Zeposia (ozanimod).

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