With Rare Exceptions, Plans Stick With Generics for Epilepsy With Chart: Current Market Access to Epilepsy Medications
Pharmaceutical treatment for different types of epilepsy generally still relies on tried-and-true generics, despite recent efforts by drug manufacturers to introduce new branded medications into the mix, PBM insider...
Prime Inks Trio of Value-Based Pacts for Migraine Drugs
In recent weeks, Prime Therapeutics LLC has entered into not one, not two, but three value-based contracts with drug manufacturers for a trio of migraine medicines. The PBM owned by 18 Blue Cross and Blue Shield pla...
News Briefs
✦ The FDA on Dec. 18 issued an emergency use authorization for Moderna, Inc.’s vaccine for preventing COVID-19, making it the second vaccine to receive an EUA. The Moderna vaccine’s EUA allows it to be distrib...
Hy-Vee’s New PBM Will Likely Need a Niche to Compete
Midwestern supermarket chain Hy-Vee, Inc. launched a new PBM subsidiary on Dec. 3, joining the already-crowded ranks of retail stores that have done the same, such as Costco Wholesale Corp., The Kroger Co. and Walgr...
Plans Step Up Use of Pharmacists in Direct Care, Data Analysis
Multiple insurers are increasing their use of pharmacists — both those they employ and pharmacists in retail settings — to help deliver care to hard-to-reach members who are at risk of poor health outcomes.
T...
Medicaid Programs Face Gene and Cell Therapy ‘Hurricane’
Though cutting-edge gene and cell therapies can transform patients’ lives, they’ve strained pharmacy budgets across the health care sector, and state Medicaid programs are no exception. With dozens of such thera...
Specialty Drug Spending Continues to Rise, Driven by Higher Utilization
Per-member per-year (PMPY) specialty drug spending rose 13.6% from 2018 to 2019, according to Pharmaceutical Strategies Group’s annual report, which analyzed 45 million pharmacy claims and 54 million medical claim...
Oral Alternatives to Injectables Still Face Stiff Competition
In its latest quarterly Drug Pipeline Insights Report, OptumRx includes a diverse array of medications that the UnitedHealth Group-owned PBM believes are likely to make a market impact when they’re approved by the...
News Briefs
✦ Documents that will be reviewed by an FDA panel on Dec. 10 conclude that Pfizer Inc.’s vaccine for the novel coronavirus offers meaningful protection against the virus within 10 days of initial dosing, tipping...
Rebate Rule Rises From Dead, but Could Still Be Doomed
On Nov. 20, HHS finalized a once-tabled regulation that would revamp the Medicare prescription drug rebate system. While that may seem to be unwelcome news to the health insurers and PBMs that have vocally opposed t...