Radar on Drug Benefits

In the 2020 Drug Trend Report recently released by Evernorth, the Cigna Corp. division added yet another chapter to the growing volume of data detailing the profound effects that the COVID-19 pandemic has had on health care.

On the one hand, the massive amount of deferred routine and elective health care utilization had a dampening effect on the number of new medication users that Evernorth — which houses the PBM Express Scripts — recorded in 2020. New users of asthma/COPD medications dropped the most, by 7.1% year over year, likely reflecting the avoidance of clinical settings among a group that is at particular risk of contracting severe COVID-19. People newly treated with drugs for high blood pressure and inflammatory conditions were the second and third most impacted groups, declining by 5.3% and 5.2%, respectively (see infographic, p. 4).

GoodRx Inc. has captured the attention of the pharmaceutical industry by putting pricing data on patients’ smartphones, often allowing them to choose between multiple prices for one drug at the pharmacy counter. While the startup — which went public last fall — unquestionably saves money for consumers, some experts say that it is a viable business only because of dysfunction in the broader drug channel.

GoodRx’s main business is a smartphone-based coupon program, which also includes price comparison tools. The company aggregates coupons by contracting with a number of PBMs, including Cigna Corp.’s Express Scripts, and offering patients the cheapest price for a drug among those partners’ negotiated network rates. If a patient uses a GoodRx coupon, the company collects a fee from a partner PBM. GoodRx debuted on the stock market on Sept. 23, closing out its first day as a public company at $50.50 per share — up from its initial public offering price of $33 per share. As of April 8, it was trading at $40.43.

Uber, seeking to expand its prescription delivery business nationwide, has inked a deal with pharmacy home delivery start-up ScriptDrop that makes Uber the default delivery app for a network of grocery store and independent pharmacies that spans 37 states.

The deal, which is just one of many corporate moves in the pharmacy delivery space, positions Uber to take advantage of the vastly increased consumer demand for home delivery services sparked by the pandemic.

✦ Mississippi Attorney General Lynn Fitch (R) has hired an external law firm to investigate whether Centene Corp. overcharged the state when managing pharmacy benefits for its Medicaid managed care program, the Daily Journal reported on March 23. The article noted that Ohio’s attorney general, Dave Yost (R), is working with the same firm in that state’s recently unveiled lawsuit against Centene, which claims its subsidiary Buckeye Health Plan used a network of PBM subcontractors to “fleece taxpayers out of millions” of dollars — a claim that the insurer denies. Read more at https://bit.ly/3lOpoZ9.

✦ The National Institute of Health (NIH) Data Safety and Monitoring Board raised concerns on March 23 that initial data that AstraZeneca PLC had just released regarding a clinical trial for its COVID-19 vaccine “may have included outdated information from that trial, which may have provided an incomplete view of the efficacy data.” AstraZeneca’s vaccine has not yet been authorized for emergency use in the U.S., but it is stirring up controversy overseas. Multiple countries recently temporarily suspended use of the shot over concerns about its side effects before European regulators affirmed their confidence in its safety, according to news reports. Read the NIH’s statement at https://bit.ly/39bb6gb.

As the U.S. continues to grapple with the COVID-19 pandemic, people with cancer continue to unsurprisingly be hesitant to visit a provider office or hospital for treatment. So, Cancer Treatment Centers of America (CTCA) is working with CVS Health Corp. to bring therapies into certain patients’ homes, helping keep immunocompromised people safer and allowing them to continue much-needed cancer treatment.

Multiple studies have shown how the pandemic has affected all aspects of cancer care, from screening and diagnostic workups to actual oncology treatments, follow-up services and patient support.