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Radar On Market Access: Magellan Rx Initiates Oncology Biosimilars Program

Posted by Judy Packer Tursman on Jun 20, 2019

Magellan Rx Management, the PBM division of Magellan Health, Inc., on June 4 announced its launch of an oncology biosimilars program, preparing its health plan customers for the expected market entry of biosimilars for three cancer-fighting drugs — Herceptin, Rituxan and Avastin — later this year, AIS Health reported.

"Oncology is by far the largest therapeutic area for drug spend on the medical benefit, and it is even higher in Medicare," Steve Cutts, senior vice president and general manager for Magellan Rx's specialty drug unit, tells AIS Health. Thus, he says, the PBM will be focusing the oncology biosimilars program "on all lines of business for our clients."
 
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Topics: Specialty, Industry Trends, Market Access

Radar On Market Access: Payers Are Wary as First NASH Drugs May Hit U.S. Market Soon

Posted by Judy Packer Tursman on Jun 18, 2019

Doctors trying to treat patients with nonalcoholic steatohepatitis (NASH) — a serious type of nonalcoholic fatty liver disease (NAFLD) that, if left untreated, may progress to cardiovascular disease, cirrhosis, cancer and possibly the need for a liver transplant — soon may have new options in their arsenal beyond promoting exercise and diet. The first-ever NASH drugs are expected to hit the U.S. market as early as 2020 to help address this increasingly prevalent, complex disease spawned largely by the obesity epidemic and surge of type 2 diabetes in the U.S., AIS Health reported.

Dieterich says the entry of first-ever NASH medications will "definitely" offer significant benefit to patients. "There's no question [the drugs will help] — in combination with diet and exercise," says Douglas Dieterich, M.D., director of the Institute for Liver Medicine at Mount Sinai Health System. "It will have to be the whole package."
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Topics: Specialty, Industry Trends, Market Access, Product Release, Provider, Payer

MMIT Reality Check on Ankylosing Spondylitis (Jun 2019)

Posted by Matt Breese on Jun 14, 2019

According to our recent payer coverage analysis for ankylosing spondylitis 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.

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

Formulary Search Rebrand Enhances the Big Picture, Adds Medical Benefit View

Posted by MMIT on Jun 13, 2019

MMIT on July 1 will rebrand Formulary Search as Coverage Search, a move that reflects the full portfolio of our capabilities, as well as the complex variances between pharmacy and medical benefit coverage, and the industry's shift toward increasingly restrictive coverage policies. You will be able to add a comprehensive new package on medical benefit coverage and policies, creating a more complete picture of the entire market access landscape.

New Medical Benefit View: "Previously, clients would think Formulary Search means formularies, so it means pharmacy benefit products only. But now we can help brands create a more complex strategy so that they can speak to coverage across benefit types," says Greg Lee, a product manager at MMIT. "This is a really important thing for our clients, because the way insurance companies are covering products — particularly physician-injected drugs, IV drugs and hospital-administered drugs — is changing, and insurance companies are getting more complex in how they create utilization management techniques on both benefits."
 
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Topics: Market Access, Product Release

Radar On Market Access: Payers Will Likely Use Various Tactics to Manage Zolgensma

Posted by Angela Maas on Jun 11, 2019

With the first therapy north of $1 million gaining FDA approval last month, payers likely will implement a variety of strategies to manage Zolgensma (onasemnogene abeparvovec-xioi), a one-time gene therapy from AveXis, Inc., a Novartis company. For now, many uncertainties exist with respect to the new treatment and what its place will be in spinal muscular atrophy (SMA) care, AIS Health reported.

According to Lee Newcomer, M.D., principal at Lee N. Newcomer Consulting LLC, payers likely will implement "strict enforcement of the label restrictions, advisory panels to develop clinical criteria for therapy [and] highly specific provider networks to ensure that the therapies are given correctly."
 
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Topics: Specialty, Industry Trends, Market Access, Product Release, Provider, Payer

MMIT Reality Check on Urothelial/Bladder Cancer (Jun 2019)

Posted by Matt Breese on Jun 7, 2019

According to our recent payer coverage analysis for urothelial/bladder cancer 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.

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

Radar On Market Access: Oncology Is Experiencing Surge Of Innovation — and Prices

Posted by Angela Maas on Jun 6, 2019

The oncology space continued its trend of developing innovative therapies — both those launching and in the pipeline — in 2018. That's according to a new report from the IQVIA Institute for Human Data Science titled Global Oncology Trends 2019: Therapeutics, Clinical Development and Health System Implications. And while the outlook continues to look promising in terms of the science, it may pose issues to the health care system that need to be resolved in order to take full advantage of next-generation oncology products, AIS Health reported.

The 15 new oncology drugs and one supportive care drug launched last year for 17 tumor types marked a record. "Importantly, one of the new drugs is tissue-agnostic" — Loxo Oncology, Inc. and Bayer Corp.'s Vitrakvi (larotrectinib) — noted Murray Aitken, executive director of the institute, during a May 23 media call to discuss the report’s findings. "Over half of the new drugs are oral therapies, continuing this trend toward more of the targeted, innovative therapies being available in an oral form. Two-thirds of the new drugs have an orphan indication, continuing this trend towards cancer being redefined into narrower segments."
 
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Topics: Industry Trends, Market Access, Data & Analytics

MMIT Reality Check on Endometriosis (May 2019)

Posted by Matt Breese on May 31, 2019

According to our recent payer coverage analysis for endometriosis 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.

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

MMIT Reality Check on Pain Narcotic Opioid (May 2019)

Posted by Matt Breese on May 24, 2019

According to our recent payer coverage analysis for pain narcotic opioid 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.

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

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