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Judy Packer Tursman

Senior Reporter, Health Plan Weekly and Radar on Drug Benefits

Recent Posts

Radar On Market Access: Civica Rx Aims to Provide 14 Drugs in Short Supply in '19

Posted by Judy Packer Tursman on Mar 19, 2019

Since its launch in 2018, Civica Rx, the new not-for-profit generic drug and pharmaceutical company run by health systems and hospitals, tells AIS Health it has made solid progress in its ongoing effort to address persistent shortages of certain drugs administered within hospitals' four walls.

According to Civica spokesperson Debbi Ford, Civica first aims to provide 14 vital drugs, "mostly sterile injectables such as anesthesia medications, antibiotics, and pain medications and expects to deliver these products this year," she says.
 
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Topics: Industry Trends, Product Release, Data & Analytics, Provider, Payer

Trends That Matter for Drug Spending

Posted by Judy Packer Tursman on Mar 14, 2019

For its first annual drug trend report as a part of Cigna Corp., Express Scripts Holding Co. said it had achieved a record low drug trend of 0.4% across its clients' employer-sponsored commercial plans in 2018. Overall, the PBM reported savings of $45 billion for its clients last year, AIS Health reported.

The PBM cited "an unprecedented 0.3% decline" in per-beneficiary drug spending across Medicare plans. Overall, there was a 1.4% decrease in unit cost trend, which allowed clients to absorb a 1.1% increase in utilization, the PBM said. Oncology replaced diabetes as Medicare’s top therapy class by per member per year spend
.
 
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Topics: Industry Trends, Data & Analytics

Radar On Market Access: What Is Behind CVS Health’s LTC Woes?

Posted by Judy Packer Tursman on Mar 7, 2019

Almost four years after CVS Health Corp. spent nearly $13 billion to acquire Omnicare, the long-term-care (LTC) pharmacy business attracted negative attention as a major contributor to "headwinds" in the company's report on fourth quarter and full-year 2018 financial results, AIS Health reported.

For the quarter ended Dec. 31, CVS Health reported a net loss of $421 million on revenues that increased 12.5% to $54.4 billion year over year. Losses reflect $2.2 billion in quarterly and $6.1 billion in full-year 2018 "goodwill impairment charges" related to its LTC business, the company said.
 
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Topics: Industry Trends, Data & Analytics

Radar On Market Access: Express Scripts Reports Record Low Drug Trend Across Commercial Plans in 2018

Posted by Judy Packer Tursman on Feb 19, 2019

For its first annual drug trend report as a part of Cigna Corp., Express Scripts Holding Co. said it had achieved a record low drug trend of 0.4% across its clients' employer-sponsored commercial plans in 2018. Overall, the PBM reported savings of $45 billion for its clients last year, AIS Health reported.

The PBM cited "an unprecedented 0.3% decline" in per-beneficiary drug spending across Medicare plans. Overall, there was a 1.4% decrease in unit cost trend, which allowed clients to absorb a 1.1% increase in utilization, the PBM said. Oncology replaced diabetes as Medicare’s top therapy class by per member per year spend.
 
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Topics: Industry Trends, Market Access, Data & Analytics, Provider, Payer

Radar On Market Access: Specialty Drug Pipeline Holds Promise Amid High Costs

Posted by Judy Packer Tursman on Jan 24, 2019

Blockbuster pharmaceuticals scheduled for launch in 2019 are expected to have a significant impact in treating certain cancers, spinal muscular atrophy, inflammatory conditions and some mental illnesses, according to Express Scripts Holding Co. With specialty medications managed through the pharmacy benefit now accounting for 41% of health plans' total pharmacy spend, the PBM asserts it is crucial for plans to understand the product pipeline and create strategies to manage new, costly drug therapies, AIS Health reported.

On the new drug front, Prime Therapeutics, in its December 2018 monthly update on the specialty pipeline, cites an annual wholesale acquisition cost (WAC) of $203,100 for Pfizer’s Daurismo (glasdegib), an oral drug approved by the FDA in combination with intravenous low-dose cytarabine to treat newly diagnosed acute myeloid leukemia in elderly and certain other adult patients. The Blues-affiliated PBM also points out that Loxo Oncology's Vitrakvi (larotrectinib), approved by the FDA to treat adult and pediatric patients with certain solid tumors, has an average annual WAC for an adult patient of $393,600.
 
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Topics: Specialty, Product Release

Radar On Market Access: Vermont Pushes Ahead on Canadian Drug Importation

Posted by Judy Packer Tursman on Jan 17, 2019

A new report concludes that if Vermont undertakes wholesale importation of prescription drugs from Canada, such a program could achieve cost savings for the state's commercial payers. But achieving benefits requires an emphasis on program mechanics, and Vermont's own effort is far from a done deal — with the state's largest health insurer pointing out that administrative costs and hurdles, which may be significant, are not quantified in this feasibility study, AIS Health reported.

The state's 14-page report on the preliminary design of the "Canadian Rx Drug Import Supply Program," written with the National Academy for State Health Policy’s (NASHP) technical assistance, estimates savings of $1 million to $5 million annually, based on just 17 high-spend drugs identified for two of the state’s three major carriers.
 
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Topics: Specialty, Data & Analytics, Payer

Perspectives on FDA’s Approval of New Opioid Formulation

Posted by Judy Packer Tursman on Dec 13, 2018

When a highly potent new opioid formulation was approved by his agency on Nov. 2, FDA Commissioner Scott Gottlieb, M.D., downplayed safety concerns about AcelRx's Dsuvia. He stressed the importance of the painkiller for military use and the "very tight restrictions being placed on the distribution and use of this product," AIS Health reported.

In general, PBM and health plan experts say such restrictions likely will hold and keep the drug within its proper niche, and the regulatory green light for Dsuvia shouldn't interfere with broad ongoing efforts to better manage opioid use in the U.S.

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

Radar On Market Access: Prime PBM's Studies Show Promise for Managing Opioids

Posted by Judy Packer Tursman on Nov 20, 2018

Researchers from Prime Therapeutics LLC recently presented studies on two approaches to managing the use of opioid medications, AIS Health reported.

In the first opioid study, Florida Blue, Prime and Walgreens piloted a program where pharmacists gave a one-page opioid safety guide to Florida Blue members whose claim histories showed high opioid and controlled substance use when they picked up opioid prescriptions from a Walgreens pharmacy. The guide explained safe use, safe storage, safe disposal and overdose prevention for opioids, and included information on naloxone, a treatment used to counter the effects of an opioid overdose.

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

Radar On Market Access: FDA’s OK of Opioid Makes ‘Diversion of Even One Tablet’ Risky

Posted by Judy Packer Tursman on Nov 15, 2018

When a highly potent new opioid formulation was approved by his agency on Nov. 2, FDA Commissioner Scott Gottlieb, M.D., downplayed safety concerns about AcelRx’s Dsuvia. He stressed the importance of the painkiller for military use and the "very tight restrictions being placed on the distribution and use of this product," AIS Health reported.

In general, PBM and health plan experts say such restrictions likely will hold and keep the drug within its proper niche, and the regulatory green light for Dsuvia shouldn't interfere with broad ongoing efforts to better manage opioid use in the U.S.
 
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Topics: Specialty, Market Access, Product Release, Payer

Radar On Market Access: PhRMA, Feds Spar Over Where To Place Drug Pricing Details

Posted by Judy Packer Tursman on Nov 6, 2018

The 15th of October turned into a day of dueling proposals on the best way for pharmaceutical manufacturers to provide consumers with more information on medication prices. America’s Health Insurance Plans (AHIP) tells AIS Health that it sees merit in the federal government’s approach, while the pharma industry’s plan falls short.

It began with a pre-emptive strike in the morning when the Pharmaceutical Research and Manufacturers Association of America (PhRMA), stressing its commitment to price transparency, issued a press release.

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Topics: Specialty, Industry Trends, Provider