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Judy Packer Tursman

Senior Reporter, Health Plan Weekly and Radar on Drug Benefits

Recent Posts

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: Payer, Specialty, Data & Analytics

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: Payer, Industry Trends, Data & Analytics, Provider

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

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: Payer, Specialty, Market Access, Product Release

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: Industry Trends, Specialty, Provider

Radar On Market Access: Prime’s New Formulary Excludes Many Drugs Just Added in 2018

Posted by Judy Packer Tursman on Oct 11, 2018

Against the backdrop of giant PBMs' megadeals, mid-sized PBMs such as Prime Therapeutics LLC are strategizing to remain competitive. As part of its effort, Prime tells AIS Health it intends to exclude dozens of drugs from its formulary effective Jan. 1 — and most of the drugs being eliminated only entered the market in 2018.
 
Prime's national NetResults Formulary is eliminating 30 to 35 drugs, for a total of 303 exclusions, for 2019, says David Lassen, Pharm.D., chief clinical officer of the PBM, which is collectively owned by 18 Blue Cross and Blue Shield plans.
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Topics: Industry Trends, Payer, Specialty, Market Access

Radar On Market Access: Payers Wait for Gilead’s HCV Generics to Hit Market Soon

Posted by Judy Packer Tursman on Oct 2, 2018

Many payers likely are keeping a close eye on how the pharma industry reacts to Gilead Sciences, Inc.'s Sept. 24 announcement that it intends to soon launch steeply discounted generic versions of two of its chronic hepatitis C virus (HCV) drugs. The biopharma company says these generics will become available in January 2019 in the U.S. — a move that PBM Express Scripts Holding Co. describes as a win for payers and patients alike, AIS Health reported. 
 
According to Gilead, its newly created subsidiary, Asegua Therapeutics, will sell authorized generics of Harvoni and Epclusa "at a list price of $24,000 for the most common course of therapy."
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Topics: Industry Trends, Payer, Specialty, Provider, Data & Analytics

Trends That Matter for 2019 PBMs' Exclusions

Posted by Judy Packer Tursman on Sep 27, 2018

Leading pharmacy benefit managers (PBMs) recently released updates to their 2019 national formularies. As of Jan. 1, Express Scripts Holding Co. will introduce 48 new formulary exclusions in its 2019 National Preferred Formulary (NPF), which the PBM says will help drive out waste, AIS Health reported.

Adam Fein, Ph.D., president of Pembroke Consulting, Inc. and CEO of Drug Channels Institute, notes that Express Scripts, for the first time, excluded products in two specialty categories: HIV antiretrovirals and Factor VIII recombinant products for hemophilia treatment.

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Topics: Specialty, Industry Trends, Branding & Marketing, Data & Analytics