Contact

Payer

Pharma

Provider

Formulary guidance and transparency from P&T to point of care

Radar On Market Access: Generic Advair May Help Reduce COPD Costs

Posted by Jane Anderson on May 21, 2019

A new generic alternative for GlaxoSmithKline's Advair Diskus (fluticasone/salmeterol) provides payers with the chance to better manage care in chronic obstructive pulmonary disease (COPD), a condition in which high out-of-pocket costs often lead to lower compliance and an increased risk of hospitalization, AIS Health reported.

Advair Diskus, a combination long-acting beta-agonist and an inhaled corticosteroid, has been one of the most common drugs used for COPD, a condition largely dominated by brand products. The generic, marketed by Mylan and approved Jan. 30, joins generics for two additional COPD devices: a generic for Ventolin HFA (albuterol) and one for Proair HFA (albuterol).
 
Read More

Topics: Industry Trends, Market Access, Product Release, Provider, Payer

MMIT Reality Check on Chronic Idiopathic Constipation (May 2019)

Posted by Matt Breese on May 17, 2019

According to our recent payer coverage analysis for chronic idiopathic constipation treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT's team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

Read More

Topics: Specialty, Market Access, Payer, Branding & Marketing

Perspectives on BioScrip/Option Care Deal

Posted by Angela Maas on May 16, 2019

Two of the country's largest independent infusion services providers recently unveiled that they have entered into a merger agreement. After coming together, BioScrip, Inc. and Option Care Enterprises, Inc. would be the No. 2 home/alternate site infusion provider in the United States, AIS Health reported.

Under the terms of the deal, publicly traded BioScrip would issue new shares to Madison Dearborn Partners, LLC and Walgreens Boots Alliance, Inc., which are the Option Care shareholders, giving them 80% of BioScrip's stock, with current BioScrip shareholders holding the remaining 20%. The new company would be publicly traded.
 
Read More

Topics: Specialty, Provider

Radar On Market Access: Use of Biologics, Biosimilars Showed Rapid Uptake in 2018

Posted by Angela Maas on May 16, 2019

Almost 5.8 billion prescriptions were dispensed in the United States in 2018, an increase of 2.7% over the previous year, according to the IQVIA Institute for Human Data Science’s report Medicine Use and Spending in the U.S.: A Review of 2018 and Outlook to 2023, AIS Health reported.

Retail and mail pharmacies dispensed 127 million specialty prescriptions last year, an increase of 15 million since 2014. In 2018, for the second year in a row, specialty prescription volume grew more than 5% although the medicines accounted for only 2.2% of prescriptions overall. With an increase in the availability of oral and self-injected specialty therapies, these drugs "are increasingly dispensed through retail pharmacies," said Murray Aitken, executive director of the institute, during a May 6 press call.
 
Read More

Topics: Industry Trends, Data & Analytics, Provider, Payer

Radar On Market Access: CBO Says Proposed Rebate Rule Will Cost Government $177B

Posted by Angela Maas on May 14, 2019

When HHS unveiled a proposed rule in late January aimed at eliminating drug rebates in Medicare Part D and Medicaid managed care, the proposal was met with mixed responses. A recently released score from the Congressional Budget Office (CBO) calls into question whether the administration chooses to move forward with the proposal in its current form, AIS Health reported.

The proposal would do away with the safe harbor protection in the anti-kickback statute for rebates negotiated between manufacturers and PBMs starting Jan. 1, 2020.
 
Read More

Topics: Industry Trends, Data & Analytics, Provider, Payer

MMIT Reality Check on Narcolepsy (May 2019)

Posted by Matt Breese on May 10, 2019

According to our recent payer coverage analysis for narcolepsy treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT's team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

Read More

Topics: Specialty, Market Access, Payer, Branding & Marketing

Trends That Matter for Colorectal Cancer Medications

Posted by Angela Maas on May 9, 2019

As innovations in digital capabilities continue to be used with various health care products, Proteus Digital Health, Inc. is developing a suite of what it terms digital medicines. And while the company has been working on such products for a few years, it recently came out with the first such product within the oncology space, AIS Health reported.

Proteus is partnering with Fairview Health Services and the University of Minnesota Health to offer oral capecitabine combined with an ingestible sensor to treat stage 3 and stage 4 colorectal cancer patients
 
Read More

Topics: Industry Trends, Data & Analytics

Radar On Market Access: CMS Extends Options to States to Test Innovative Dual-Eligible Care Models

Posted by Lauren Flynn Kelly on May 9, 2019

Although independent evaluations of ongoing demonstrations to integrate care for dual-eligible Medicare-Medicaid beneficiaries are still underway, an April 24 letter from CMS Administrator Seema Verma signaled the agency's commitment to proving the value of the models as well as testing alternatives, AIS Health reported.

In the letter to state Medicaid directors, CMS extended three new opportunities to "test state-driven approaches" for integrating duals' care:
 
Read More

Topics: Industry Trends, Provider, Payer

Radar On Market Access: Magellan Sees Success With Infliximab Biosimilars

Posted by Jane Anderson on May 7, 2019

Magellan Rx Management saw a significant shift in utilization from Janssen Biotech, Inc.'s Remicade (infliximab) to biosimilars after it implemented a comprehensive utilization management (UM) program, resulting in 34% drug cost savings, the PBM reported.

The program, which began in late 2017, involves any patient prescribed an infliximab product for any indication, and is available to all payer clients as an opt-in option, Steve Cutts, senior vice president and general manager, tells AIS Health.
 
Read More

Topics: Industry Trends, Market Access, Data & Analytics, Provider, Payer

MMIT Reality Check on Low Testosterone (May 2019)

Posted by Matt Breese on May 3, 2019

According to our recent payer coverage analysis for low testosterone treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT's team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

Read More

Topics: Specialty, Market Access, Payer, Branding & Marketing