Datapoint

Datapoint: Molina Set to Acquire My Choice Wisconsin

Molina Healthcare Inc. will acquire My Choice Wisconsin, a small Medicaid MCO based in Wauwatosa, Wis., for $150 million in cash. A July 13 press release from the insurer said that “the transaction is expected to be immediately accretive to Molina’s adjusted earnings per share” and will close later in 2022 pending regulatory review. My Choice Wisconsin’s health plan currently enrolls 28,226 fully insured Medicaid members.

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Datapoint: Centene Completes PANTHERx Sale

Centene Corp. last week completed its sale of specialty pharmacy arm PANTHERx to Vistria Group, General Atlantic and Nautic Partners. Centene originally purchased the rare drug company in December 2020. The insurer said in a July 14 press release that it intends to use the windfall to “repurchase stock and the balance to reduce debt.” Centene is also in the process of selling Magellan Rx to Prime Therapeutics, with the two deals valued at $2.8 billion. Centene is currently the fourth-largest insurer in the U.S., with 20,988,628 members.

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Datapoint: Clover Health to Expand MA Presence

Startup insurer Clover Health will expand its Medicare Advantage presence in three states for the 2023 plan year; Georgia, South Carolina and Tennessee. The insurer also said it will leave two of its smaller markets, El Paso County in Texas and Pima County in Arizona. In a July 14 press release, Clover Health said it hopes its Georgia expansion replicates its previous success in New Jersey, by “significantly increasing the breadth and depth of its provider network throughout the state with the addition of dozens of hospitals, health systems and key provider partners across the region, aligning approximately 5,000 new primary care physicians and specialists.” Clover Health currently enrolls 84,948 MA members, with 82.7% enrolled in a New Jersey plan offering.

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Datapoint: Horizon Snags Gout Label Expansion for Krystexxa

The FDA on July 8 approved a label expansion for Horizon Therapeutics’ Krystexxa. The injectable, in combination with methotrexate, will be the first treatment available for uncontrolled gout in patients whose symptoms have not responded to other therapies. The drug was first approved in 2010. For the treatment of gouty arthritis, Krystexxa currently holds covered or better status for 57% of all insured lives under the pharmacy benefit. Krystexxa is not covered for 34% of lives.

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Datapoint: Delaware Awards New Medicaid Managed Care Contracts

The state of Delaware this week awarded new Medicaid managed care contracts to three payers; incumbents Highmark Health and AmeriHealth Caritas, plus new entrant Centene Corp. "We are excited to work with the state and providers on proven models of value-based care to deliver transformative healthcare and improve the health of Diamond State Health enrollees across the state,” Brent Layton, president and chief operating officer with Centene, said in a July 12 press release. The new contracts, which are set to begin January 1, 2023, represent a shift to value-based care for the state. Delaware’s managed care plans currently serve 240,411 lives, representing 85.6% of the overall Medicaid population.

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Datapoint: Novartis Reportedly Mulls Sandoz Spinoff

Novartis is reportedly considering spinning off its $25 billion generics unit, Sandoz, according to a June 30 report in Bloomberg. Novartis has been conducting a strategic review of Sandoz since last fall, and plans to share results by the end of this year. Novartis saw $9.2 billion in generic drug sales in 2021, and sales of $9.4 billion are projected for 2022. Its top-selling retail generics in the U.S. are omeprazole, tamsulosin hydrochloride and latanoprost.

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Datapoint: Alignment Healthcare to Expand MA Footprint

Alignment Healthcare on June 29 said it plans to expand its Medicare Advantage footprint into two new states, Florida and Texas, and into additional counties in the four states it currently serves. Pending CMS approval, the Orange, Calif.-based insurer will enter Clay, Duval, Manatee and Sarasota counties in Florida, and El Paso and Hudspeth counties in Texas for the 2023 plan year. Alignment says its latest expansion plans will enable it to reach an additional 1.1 million Medicare-eligible seniors, for a total of 8.2 million Medicare-eligible adults across 52 counties in six states next year. The insurer currently enrolls 94,544 MA members.

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Datapoint: Oscar Launches New Member Engagement Technology

Insurance startup Oscar Health on June 29 unveiled a new member communication platform, its Next Best Actions engine. The messaging framework targets member behaviors, identifying patterns in opportunity to drive behavior changes and prioritizing the most important actionable messages for users. Oscar currently serves 1,037,360 members nationwide, with 92.1% enrolled in exchange plans.

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How Can Pharma Incorporate the Commercial Aspect Into Drug Development?

When pharma companies launch a successful product, the process leading up to that point contains many key decisions from various teams across a manufacturer, including commercial. And with science leading to more and more innovations and many drugs coming to market via an accelerated process, it’s critical now more than ever to understand when to bring in the commercial team and how it can help with the development of a drug and its ultimate success in the market.

During a recent webinar, which was part of the Fierce Leaders in Sciences Forum sponsored by Fierce Pharma, moderator Lisa Johnson Pratt, a board member for Assembly Biosciences, kicked off the discussion by asking what the biggest challenges are for companies that are trying to bring a strong commercial point of view and input into the product development process.

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Datapoint: Pfizer Seeks Full Approval for Paxlovid

Pfizer last week announced it has asked the FDA for full standard approval of its COVID-19 antiviral, Paxlovid, in patients at risk of developing severe illness from the virus. Paxlovid is currently Pfizer’s No. 2 best-selling drug, according to data from Evaluate Pharma. Evaluate projects total Paxlovid sales of $29.4 billion in 2022, dropping to $14.8 billion in 2023.

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