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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

Perspectives on Biosimilars Market in 2019

Posted by Angela Maas on Mar 7, 2019

Biosimilars are one way that payers had hoped to bring down spending on pharmaceuticals, but as of yet, these products have had little impact in the United States. As of mid-January, the FDA had approved 17 biosimilars, but only a handful actually are available in the U.S. However, the products may pick up more traction in 2019, with some significant ones potentially coming to market, AIS Health reported.

According to Lynn Nishida, R.Ph., vice president of clinical product at WithMe Health, "More biosimilars are in the pipeline, but, sadly, expect continued issues of patent litigations that delay marketing of biosimilars soon after their approval or force biosimilar manufacturers to consider launching products at risk" before a lawsuit has been settled, potentially setting themselves up to be responsible for paying damages if they lose the case.
 
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Topics: Specialty, Industry Trends, Market Access, Product Release, 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: Diplomat Pharmacy Postpones Earnings Release Amid PBM Struggles

Posted by Leslie Small on Mar 5, 2019

Diplomat Pharmacy Inc.'s stock value plummeted recently after the company said it would delay the release of its fourth-quarter and full-year earnings results — primarily because of difficulties with its PBM business, AIS Health reported.

Diplomat entered the PBM space in 2017 when it acquired National Pharmaceutical Services and LDI Integrated Pharmacy Services. The company disclosed in a Feb. 22 press release that it anticipates writing down a "significant portion" of its PBM business' approximately $630 million in assets. It also said it is withdrawing its preliminary 2019 full-year earnings outlook, in part because it's seen "additional customer losses in its PBM business since early January," which combined with a "softer outlook for client wins and other factors" has led to a lower-than-expected outlook for its PBM business in 2019.
 
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Topics: Industry Trends, Data & Analytics, Provider

Trends That Matter for California Medicaid Program

Posted by Carina Belles on Feb 28, 2019

Under the direction of its new governor, Democrat Gavin Newsom, California is planning to take control of the pharmacy benefit for all of the state's Medi-Cal beneficiaries, AIS Health reported.
 
Medi-Cal, California's Medicaid program, is served by more than 20 managed care organizations. MCOs are currently able to contract with a pharmacy benefits manager, but the new plan would allow the state to directly negotiate drug prices, purchase drugs in bulk and develop transparency on drug cost reimbursement.
 
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Topics: Specialty, Data & Analytics

Radar On Market Access: Highmark Expands Proving Ground for Innovative Therapies

Posted by Leslie Small on Feb 28, 2019

After Highmark Health expanded from an insurer to an integrated delivery system, the organization decided it was uniquely positioned to launch a platform to test early-stage, FDA-approved medical innovations that were struggling to attain the evidence needed for widespread adoption — and, critically, insurance reimbursement, AIS Health reported.

Nearly four years later, Highmark Health Plan and its affiliate Allegheny Health Network have changed their policies and purchasing contracts to provide therapeutic innovations to members after gathering evidence on their effectiveness. Examples include HeartFlow, which can create a 3D model of coronary arteries and blockages, and FreeSpira, a digital therapeutic that reduces debilitating panic attacks.
 
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Topics: Data & Analytics, Provider, Payer

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

Trends That Matter for M&A Activity in Specialty Pharmacy and Infusion Therapy Spaces

Posted by Angela Maas on Feb 14, 2019

The specialty pharmacy and infusion therapy spaces have certainly seen their share of merger and acquisition (M&A) activity over the years. Some challenges within those industries may have helped slow down 2018 activity a bit, observes Reg Blackburn, managing director at The Braff Group. And for 2019, we may see more of the same, AIS Health reported.

As far as specialty pharmacy trends in 2018, Blackburn points out that "the largest specialty pharmacies continue to get even larger. Payer- and chain-owned dominate. Most new entity growth is coming from large academic hospitals starting their own specialty pharmacies."
 
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Topics: Specialty, Industry Trends, Product Release, Data & Analytics

Trends That Matter for Hep C Treatment

Posted by Jane Anderson on Jan 31, 2019

A small study suggests it might be possible to shorten the length of expensive drug treatment for chronic hepatitis C virus (HCV), potentially cutting treatment time in half for 50% of patients. But managed care pharmacy clinicians say the results are far from ready to implement widely, and it’s possible the new approach might not even save money, AIS Health reported.

The study, conducted at Loyola University Chicago and three medical centers in Israel, involved only 22 patients. It used a technique called modeling-based response-guided therapy, which estimated how long it would take to completely eliminate the hepatitis C virus.
 
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Topics: Data & Analytics, Payer