Radar on Drug Benefits

✦ 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.

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.”

A recently approved brand drug for bipolar disorder will have little impact on how health plans cover these medications, experts say. Health plans will continue to encourage the use of less expensive generic bipolar drugs.

The brand drug, Allergan plc’s Vraylar (cariprazine), was approved by the FDA in May to treat depressive episodes associated with bipolar 1 disorder in adults. The drug also was previously approved to treat manic or mixed episodes associated with bipolar 1 disorder and schizophrenia in adults. It is an oral, once-daily atypical antipsychotic.

With the federal government consumed by responding to the COVID-19 outbreak, the possibility of Congress passing drug-pricing legislation — once a top priority for the Trump administration — might seem dim. But analysts say it’s very possible that something like an overhaul of the Medicare Part D benefit, upon which there is bipartisan agreement, could still make its way into legislation that federal lawmakers pass in the coming weeks or months to address the ongoing public health crisis.

After days of increasingly tense negotiations, the Trump administration and Senate leaders reached a deal in the early hours of March 25 on a stimulus package worth more than $2 trillion that aims to provide relief for Americans and businesses struggling from the widening economic damage wrought by COVID-19. The COVID-19 pandemic, which as of March 25 caused more than 700 deaths in the U.S., has pummeled the stock market and triggered scores of job losses as many of the country’s most populous cities and states shut down non-essential businesses to slow the virus’ spread.