Radar on Drug Benefits

Uber Technologies, Inc. announced late last month that it would embed same-day prescription delivery on its Uber Health app, expanding the offerings available to its health care provider and payer customers. Although the feature could help patients adhere to their medications and save costs for employers, PBMs and health plans, Uber faces numerous competitors in a crowded field and could have challenges getting the delivery feature covered, according to health care experts who spoke with AIS Health. 

Uber Health, which launched in 2018, is primarily used for coordinating non-emergency medical transportation of patients to and from hospitals and other health care facilities. The company entered the prescription delivery business in August 2020 through a partnership with NimbleRx in Seattle and Dallas. And two years ago, the company formed a partnership with ScriptDrop to make Uber the default delivery app for a network of grocery stores and independent pharmacies in 37 states. Those stores and pharmacies already had deals with ScriptDrop, a health care information technology company founded in 2016, so they gained access to Uber’s network of drivers. 

Mark Cuban Cost Plus Drug Co., the wholesale, direct-to-consumer drug manufacturer and pharmacy launched by the eponymous entrepreneur, will sell brand-name diabetes drugs from Janssen, a division of Johnson & Johnson. Cuban also says that the company will soon sell hypothyroidism treatment Tirosint (levothyroxine). The drugs are the first brand-name products to be sold by the company, which has previously focused exclusively on generics; Cuban says that the company plans to sell whatever brand-name drugs that it can, depending on drugmakers’ interest. 

Invokana (canagliflozin), Invokamet (canagliflozin-metformin HCl) and Invokamet XR (canagliflozin-metformin HCl) are now available from the startup, according to an April 3 tweet. Invokana will cost $243.90 for a 30-day supply, while Invokamet and Invokamet XR will each cost $244.20 for a 60-day supply. During a March 23 panel on prescription drug pricing and policy convened by Vanderbilt University, Cuban said that he doesn’t expect to stop at offering just a few brand-name drugs. 

Access to the abortion pill mifepristone is in limbo following two contradictory court rulings. On April 7, U.S. District Judge Matthew Kacsmaryk ordered the FDA to suspend its approval of mifepristone, which the agency first issued in 2000. The judge gave the Biden administration seven days to appeal.

On April 10, the Dept. of Justice asked the 5th U.S. Circuit Court of Appeals to block the ruling and keep the drug on the market as litigation plays out. On April 12, the court ruled that mifepristone will remain available for now but with new restrictions, including a requirement for in-person doctor visits to obtain the drug. The Biden administration then responded that it would immediately seek emergency relief from the Supreme Court to restore full access to mifepristone.

Meanwhile, states including New York, Massachusetts, California and Washington are rushing to stockpile abortion pills.

Amid a trend of steep insulin price cuts by Eli Lilly & Co., Novo Nordisk A/S and Sanofi S.A., the state of California said it would develop its own line of affordable insulins with Civica Rx, the nonprofit drug manufacturer that launched in 2020. Experts say that patients will finally see relief from sky-high insulin prices and drug manufacturers will maintain a healthy margin — but they add that PBMs and some payers may actually see the costs of their insulin purchasing increase as rebate revenue decreases. 

California and Civica's new insulin line will, according to a Civica press release, be called CalRx and will be sold at "no more than $30 per 10 mL vial and no more than $55 for a box of five 3 mL pre-filled pens." Allan Coukell, Civica's senior vice president of public policy, tells AIS Health, a division of MMIT, that the company expects to start selling the insulin after submitting biosimilars for FDA approval starting in 2024. According to the press release, the Civica insulin line will include biosimilars glargine (which references Sanofi's Lantus), lispro (Lilly's Humalog) and aspart (Novo's Novolog).