Radar on Drug Benefits

Two lawsuits — one against federal health regulators by a drugmaker and the other against a drugmaker by the Dept. of Justice — represent the latest salvos in the dispute over whether and how drug company-supported charities can help patients pay for expensive medications.

The two suits may ultimately offer a chance to clarify what manufacturers can and cannot do to fund copay assistance charities, particularly for patients with rare diseases, says Lance Grady, who leads the market access practice at Avalere Health.

Since the first studies emerged suggesting Gilead Sciences, Inc.’s remdesivir was a promising treatment for COVID-19, speculation has abounded regarding what price the manufacturer would set for the antiviral drug. On June 29, Gilead ended that speculation by revealing that it will charge $2,340 for a typical five-day, six-vial treatment course for people covered by U.S. government health programs and $3,120 for those covered by private insurance.

Remdesivir has not been approved by the FDA, but the agency did grant the infused drug an Emergency Use Authorization for the treatment of hospitalized patients with severe COVID-19. It is being studied in multiple international trials; one U.S.-government led study found remdesivir shortened COVID-19 patients’ recovery time by 31%.

✦ Kaiser Permanente is joining Civica Rx – the not-for-profit generic drug company run by health systems and hospitals — as a governing member with a seat on the board of directors. Civica, which was founded in 2018 in a bid to address shortages of critical drugs, is already manufacturing 20 essential generic medications — “10 of which are currently being used to treat COVID-19 patients,” the organizations noted in a June 18 press release. “The COVID-19 pandemic has put a spotlight on the critical need for ensuring consistent supplies of affordable, generic medications for patients and we are proud to join with Civica Rx to help lead these efforts,” Kaiser Permanente Chairman and CEO Greg Adams said. Visit https://prn.to/37JMNDQ.

✦ Humana Inc. said it’s teaming up with a company called Pharmacy Quality Solutions (PQS) on a pilot program that aims to improve outcomes for diabetes patients. Using PQS’s EQuIPP platform, select pharmacies in Arizona, Iowa, Kentucky, North Carolina, Ohio and Texas that serve Humana Medicare Advantage members with a prescription drug benefit will be able to track the performance of their patients on two quality measures, Diabetes Control — A1c Testing and Diabetes Control — A1c Under Control, through the 2020 program year. “For pharmacies, higher performance scores will correspond to greater incentives,” a press release stated. Read more at https://bwnews.pr/2CibImo.

The FDA’s approvals of two interleukin-17A (IL-17A) antagonists to treat active non-radiographic axial spondyloarthritis (nr-axSpA) give providers new options for patients who are intolerant of non-steroidal anti-inflammatory medications (NSAIDs) and other therapies.

But the FDA’s decision to greenlight Eli Lilly and Co.’s Taltz (ixekizumab) and Novartis Pharmaceuticals Corp.’s Cosentyx (secukinumab) for the condition are unlikely to shake up plan formularies, since IL-17As currently are considered third-line treatments for the condition, PBM insiders say.