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Radar On Market Access: Sensor-Equipped Pills Draw Plans’ Interest

Posted by Matt Breese on Sep 25, 2018

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In a move that one expert says Medicaid plans will be watching closely, Magellan Health and the drug manufacturer Otsuka America Pharmaceutical, Inc. said Aug. 30 that they will work together to allow "select regional provider networks" contracted through Magellan to opt into a program involving the Abilify MyCite system, AIS Health reported.
Abilify (aripiprazole) treats schizophrenia and other mental illnesses. The MyCite system comprises Abilify tablets embedded with sensors; patches that detect and record the date and time of the pill's ingestion as well as physiological data like activity level; an app that lets patients review their data and enter additional information; and a web-based dashboard that lets providers and caregivers display and track a patient's drug ingestion patterns over time.
A 30-day supply of all the components in Abilify MyCite costs $1,650, says John A. Bardi, vice president of public affairs and digital medicine business development for Otsuka.
One in five Medicaid enrollees has been diagnosed with a serious mental illness or other behavioral health issue, and there's likely another one in five who are undiagnosed, says Jeff Myers, president and CEO of Medicaid Health Plans of America. "So anything the plans can get [in their] tool belt to ensure adherence to their drug regimen, to do what we can to keep them well, is something the plans are going to look at very carefully."
Down the road, if states consider adding Abilify MyCite to their carved-out formularies, or if managed care plans begin to roll it into their formularies, "the states are going to have some questions about how are you going to manage the benefit, and are we going to get the value out of spending this extra money," Myers says.
To that end, insurers are particularly interested in learning whether the Abilify MyCite system can reduce hospital stays among the population that Magellan and Otsuka study, he adds.

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Topics: Specialty, Market Access, Product Release, Payer