Radar on Drug Benefits

  • As World Awaits Results From Remdesivir Trials, Pricing Questions Loom

    Hydroxychloroquine and chloroquine are far from the only drugs being tested for their potential to treat COVID-19, the disease caused by the novel coronavirus that has ballooned into a pandemic.

    Another potentially promising therapy is remdesivir, an experimental antiviral drug developed by California-based Gilead Sciences, Inc. Previously, it has been tested on patients infected with Ebola and two other coronaviruses: severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

  • Express Scripts’ Value-Based Programs Save Plans $4.3B

    Express Scripts said it saved enrolled plans some $4.3 billion in 2019 through its SafeGuardRx programs, which combine multiple cost- containment strategies such as value- based contracting and payments from financial guarantees.

    The PBM first launched its “cure value” program in 2015 for hepatitis, shortly after the FDA approved Gilead Sciences’ Harvoni (ledipasvir/sofosbuvir), the first among a slate of pricey second-generation hepatitis C therapies.

  • News Briefs

     President Donald Trump’s statements touting chloroquine and hydroxychloroquine as promising treatments for the new coronavirus has triggered hoarding of the drug and subsequent shortages, the New York Times reported. Those drugs, which have not been approved by the FDA to treat COVID-19, the disease caused by the coronavirus, are typically used to treat malaria, lupus, rheumatoid arthritis and other conditions. In response to the stockpiling of the drugs, states including Idaho, Kentucky, Nevada, North Carolina, Ohio, Oklahoma and Texas have all issued emergency restrictions or guidelines on how the drugs can be dispensed at pharmacies. Read more at https://nyti.ms/33MdDJu.

     A bill has cleared the Kentucky legislature that would require the state’s Medicaid program to pay pharmacies directly for prescription drugs, essentially cutting out the role of PBMs, the Associated Press reported on March 18. CVS Health Corp. is among the major opponents of the measure, with the firm arguing that it’s based on “flawed analysis” and would be a “costly step backwards” for Kentucky. Read more at https://bit.ly/2y6Pkui.

  • Experts: CMS Move to Cut Insulin Costs Has Limits

    Recently, CMS unveiled a new program to reduce Medicare beneficiaries’ out-of-pocket costs for insulin (RDB 3/12/20, p. 8). The voluntary model aims to lower the cost of a 30-day supply to “no more than $35” and reduce annual insulin costs by an average of $446 per person. Industry experts say the program, called the Part D Senior Savings Model, should save patients money but will have a limited impact on overall drug spending.

    “The goal of the program is a way of putting the rebates and additional pricing incentives up front to the member level,” Brian Anderson, an actuary at Milliman Inc., tells AIS Health via email. “This is not a direct point-of-sale rebate approach, but it is a similar strategy for this therapeutic category.”

  • Pharma Companies Race to Tackle COVID-19

    Since the novel coronavirus started to spread globally, a mix of legacy pharmaceutical companies and small startups have been scrambling to develop a treatment or vaccine for COVID-19, the disease caused by the virus. While developing a vaccine would take at least 12 to 18 months, drugmakers and researchers are testing existing medications used for other illnesses as potential treatments. Here’s a look at what some companies are doing:
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