Celltrion USA, Inc. signed a contract with Ventegra to include its Yuflyma (adalimumab-aaty) as a preferred drug on its formulary in both public and private insurance markets, the manufacturer said Oct. 5. Ventegra is a “major U.S. Medical Benefits Manager (MBM) who administers pharmacy benefits through its Pharmacy Services Administration (PSA) model that has been effectively displacing traditional” PBMs. The move gives Celltrion access to approximately 3.6% of the U.S. The company says it will increase its marketing so that the drug has “coverage and/or access for 40% of the U.S. population by the end of the year.” Yuflyma, a high-concentration biosimilar of AbbVie Inc.’s Humira (adalimumab), launched in July with a wholesale acquisition cost of $6,576. Celltrion also said that Yuflyma has been added to CarePartners Pharmacy’s cost savings programs. With its partners, the specialty pharmacy has access to more than 10 million plan members. It is fully accredited and licensed to service patients in all 50 states and Washington, D.C. According to The Korea Economic Daily, “CarePartners will sidestep the original Humira from its roster and refrain from enlisting other competing adalimumab biosimilars, effectively making Yuflyma the sole adalimumab product in its offerings.”
A U.S. district court judge recently struck down a federal rule allowing health plans to not count copayment assistance against members’ out-of-pocket costs. The move clears the way for plans to have to discontinue use of copay offset programs such as copayment accumulators, which have been popular tools to keep their costs down and often impact specialty therapies. But as a result of the ruling, industry experts say that patient adherence likely will improve.
U.S. District Judge John D. Bates of the U.S. District Court for the District of Columbia issued the ruling on Sept. 29.
To help patients pay for costly specialty drugs, pharma manufacturers offer assistance that can help cover their out-of-pocket costs. Companies claim that the assistance helps improve patient adherence to medications that often treat rare and deadly conditions. But critics of them say such programs incentivize drugmakers to raise prices of these agents.
The first biosimilar for the treatment of multiple sclerosis recently received FDA approval, and when it launches, Tyruko (natalizumab-sztn) from Polypharma Biologics and Sandoz Inc. will enter a competitive therapeutic class that is a high priority for management. Payers have said they expect the new treatment to have a moderate impact on their management of the other agents available to treat the condition.
On Aug. 24, the FDA approved Tyruko for the treatment of two indications: (1) adults with relapsing forms of multiple sclerosis, including clinically isolated syndrome, relapsing-remitting disease and active secondary progressive disease, and (2) adults with moderately to severely active Crohn’s disease with evidence of inflammation who have had an inadequate response to, or are unable to tolerate, conventional Crohn’s therapies and tumor necrosis factor (TNF) inhibitors.
The specialty drug landscape continues to be a dynamic space, as new agents enter the market and existing ones gain FDA approval for additional indications. Global health care and specialty pharmacy solutions organization AscellaHealth recently released its quarterly breakdown of insights into treatments within the segment.
The Q3 2023 Specialty & Rare Pipeline Digest examines new approvals and launches of specialty drugs, including biosimilars, generics, and cell and gene therapies, as well as ones in the pipeline.
Among the highlighted agents in the recently released report were Alzheimer’s disease drug Leqembi (lecanemab-irmb) from Eisai Inc. and Biogen, myasthenia gravis therapy Rystiggo (rozanolixizumab-noli) from UCB, Inc. and Pfizer Inc.’s alopecia areata medication Litfulo (ritlecitinib).
Findings from a study jointly conducted by AllianceRx Walgreens Pharmacy and Walgreen Co. reveal the importance of adherence to non-infused biologics for the treatment of rheumatoid arthritis (RA). Specifically, researchers found a connection between adherence and lower medical costs, rates of hospitalization and length of stay (LOS).
The study used data from 2019-2020 in the MarketScan Commercial Claims and Encounters databases for patients with commercial coverage, and Supplemental or Coordination of Benefits databases for Medicare beneficiaries. It also used the reporting metric of proportion of days covered (PDC) from the Pharmacy Quality Alliance (PQA), an independent non-profit organization focused on improving safety, adherence and appropriate use of medications.
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