Radar on Drug Benefits

A Missouri federal judge barred former Cigna Group executive Amy Bricker from moving to CVS Health Corp., finding that Bricker’s planned move would violate her noncompete agreement with Cigna, where she led the Express Scripts PBM. Cigna sued to block Bricker from leaving the company, arguing that Bricker’s knowledge of trade secrets and the firm’s “most highly sensitive information” would aid CVS in direct competition with Cigna. Bricker countered that her new CVS role was not meant to encompass pharmacy benefits and would not have involved any work with CVS’s Caremark PBM division. Earlier this year, the Biden administration announced an effort to ban noncompete clauses in employment agreements. 

The number of independent pharmacists remained relatively flat in 2023, according to a survey by the Pharmaceutical Care Management Association (PCMA), a PBM trade group, with 23,353 independent pharmacies in operation across the U.S. The number of independent pharmacies increased by 99 between January 2022 and January 2023, a 0.4% uptick that nearly matches the 0.5% five-year trend, the survey found. Over the past 10 years, the number of independent pharmacies has grown by 7.5%.  

When Amgen Inc.’s Amjevita (adalimumab-atto) landed on the U.S. market late last month, it became the first of several biosimilars to Humira that will finally be available to patients this year — and which will aim to topple the lucrative franchise of AbbVie’s blockbuster autoimmune condition drug. According to health care industry experts, early indications of how major PBMs are covering Amjevita speak volumes about the power of rebates and the largely untested potential for biosimilars to drive down biologic prices and capture market share. 

The arrival of Humira biosimilars has been eagerly anticipated by those who hope they’ll reduce spending on a multi-indication therapy that has long strained payer budgets — thanks in large part to AbbVie’s infamous maneuvering to stave off competition. Amjevita, for example, was first approved in 2016, but AbbVie was able to prevent its launch due to litigation over infringement on Humira patents. A settlement reached in 2017 delayed Amjevita’s U.S. launch to Jan. 31, 2023. 

Cigna Corp. filed a lawsuit on Jan. 26 against Amy Bricker, the former president of the company’s Express Scripts PBM, and CVS Health Corp., which hired Bricker last month to a C-suite position.  

The complaint in the U.S. District Court for the Eastern District of Missouri alleges that Bricker should not be allowed to join CVS due to a non-compete agreement that “prohibits her from working for any Cigna competitor.” It came three weeks after the Federal Trade Commission (FTC) proposed a rule that would ban employers from imposing non-compete agreements and as some states look more closely at such arrangements.  

The FDA on Feb. 2 granted approval for a self-administered version of Amgen Inc. and AstraZeneca plc’s Tezspire (tezepelumab-ekko), a biologic used as a preventive maintenance therapy for severe asthma. Pharmacy experts tell AIS Health, a division of MMIT, that the drug’s high price tag and high clinical thresholds mean that adoption is unlikely to spike in the short term. 

The new version of Tezspire, a human monoclonal antibody, can be self-administered by patients through a pre-filled pen. Doses last four weeks.  Tezspire is “the only biologic approved for severe asthma with no phenotype (e.g., eosinophilic or allergic) or biomarker limitation within its approved label,” per an Amgen press release. It was first approved in December 2021, But previously, the drug had to be administered by a practitioner.