RADAR on Drug Benefits

News Briefs

✦ During Centene Corp.’s Oct. 26 conference call to discuss third-quarter 2021 financial results, executives said the insurer will issue a request for proposals (RFP) in 2022 for PBM services. The move — which comes as Centene has been settling a spate of lawsuits filed by states over its PBM practices — is “going to be a huge opportunity for an external PBM,” Chief Financial Officer Drew Asher said during the company’s call with analysts.

Merck COVID-19 Drug Could Gain Emergency Use Authorization

Merck & Co. has made waves by claiming one of its antiviral drugs, molnupiravir, could reduce hospitalizations for COVID-19 by roughly half — as has the company’s announced plans to seek emergency use authorization (EUA) from the FDA for the drug.

Experts are optimistic that the drug could be the first of several new therapeutics and prophylactics for COVID-19 — but caution that molnupiravir may not be right for every patient, requires scaled-up production and could be more costly in the commercial market than many expect.

More MA-PD, PDP Members Will Be in 4-Star Plans in 2022

CMS, in its recent release of 2022 star ratings for private Medicare plans, reported that the percentage of members in plans rated 4 stars and above rose for both Medicare Advantage Prescription Drug (MA-PD) plans and stand-alone Prescription Drug Plans (PDPs).

MA-PD plans’ performance is getting the most buzz — perhaps because an eye-popping 90% of current enrollees are in plans that will be rated 4 stars or higher in 2022, up from 77% of MA-PD enrollees in 2021. Still, PDPs’ year-over-year percentage increase of members in highly rated plans is also notable.

PhRMA Blasts Poll About Gov’t Drug Price Negotiation Support

With Congress continuing to debate a measure that would allow the Medicare program to negotiate drug prices with manufacturers, a new Kaiser Family Foundation (KFF) poll has found that “large majorities” of U.S. adults support such a move, “and this support holds steady even after the public is provided the arguments being presented by parties on both sides of the legislative debate.”

But the Pharmaceutical Research and Manufacturers of America (PhRMA) is striking back, with a spokesperson sending an email to reporters on Oct. 12 that accuses KFF of “joining the partisan fray and political advocacy groups who are trying desperately to build congressional support for government price-setting.”

Prime Therapeutics Taps Amazon for Home Delivery

Prime Therapeutics LLC is launching a new kind of shopping experience for members of participating Blue Cross Blue Shield plans called MedsYourWay, and its first offering includes a home delivery option through Amazon Pharmacy.

Through the Amazon Pharmacy partnership, MedsYourWay gives consumers “simplified sign-up, real-time medication price displays and an integrated MedsYourWay prescription discount card administered by Inside Rx1,” according to a press release.

COVID-19 Treatment Candidates, at a Glance

More than a year into the pandemic, a handful of vaccines have been authorized for the novel coronavirus in the U.S., yet there is still no cure for COVID-19. Researchers and doctors have been racing to find drugs and therapies that could treat the disease or prevent people from getting infected. Only one drug, Gilead Sciences’ Veklury (remdesivir), has been approved by the FDA, while several treatments received an emergency use authorization (EUA). Here’s a look at some of the key treatments/candidates currently in play:

News Briefs

✦ A pharmacy trade group made a formal request to the Dept. of Justice, asking that the government block UnitedHealth Group’s proposed acquisition of Change Healthcare Inc. “This deal would give UHG a trove of intelligence on its smaller competitors, including thousands of independent pharmacies and their patients.

Experts: EU Will Continue to Beat US on Biosimilar Adoption

As biologics research and development becomes more granular, biosimilars may wind up both less useful and profitable than boosters of the drug category once thought. According to experts, the first wave of biologic ...

Pharma Industry Braces as Dems Hash Out Drug Price Package

Although House Democratic leaders recently suffered a setback when a trio of moderates in a key committee voted against a sweeping set of drug pricing reforms, health care policy experts tell AIS Health that the pha...

Study Flags Potential Benefit of Targeted Medication Reviews

The Part D Enhanced Medication Therapy Management Model launched in 2017 with the intention of incentivizing prescription drug plans (PDPs) to investigate new strategies to optimize medication therapy management (MT...