In an open letter, Gilead CEO Daniel O'Day argued that Gilead priced remdesivir "well below" its estimated value, considering it can save the U.S. health care system approximately $12,000 per patient by reducing the length of COVID-19 patients’ hospital stays.
In an open letter, Gilead CEO Daniel O'Day argued that Gilead priced remdesivir "well below" its estimated value, considering it can save the U.S. health care system approximately $12,000 per patient by reducing the length of COVID-19 patients’ hospital stays.
Topics: Market Access, Product Release, Provider, Payer
Perspectives on How Drug Pricing Legislation Impacts Innovation
Posted by Angela Maas on Nov 14, 2019
One of the proposals is the International Pricing Index, an effort by HHS to bring payments for Medicare Part B closer to what 16 other "developed economies" pay for these drugs. The Senate's Prescription Drug Pricing Reduction Act of 2019 proposes multiple changes to Medicare Part B and Part D, as well as Medicaid. And the House’s Lower Drug Costs Now Act proposes, among other things, requiring HHS to negotiate the prices of up to 250 drugs in Medicare without competitors. Companies not coming to an agreement would be subject to financial penalties.
Topics: Specialty, Industry Trends, Product Release, Provider, Payer
Radar On Market Access: Would Drug Pricing Legislation Impact Innovation?
Posted by Angela Maas on Oct 17, 2019
One of the proposals is the International Pricing Index, an effort by HHS to bring payments for Medicare Part B closer to what 16 other "developed economies" pay for these drugs. The Senate's Prescription Drug Pricing Reduction Act of 2019 proposes multiple changes to Medicare Part B and Part D, as well as Medicaid. And the House’s Lower Drug Costs Now Act proposes, among other things, requiring HHS to negotiate the prices of up to 250 drugs in Medicare without competitors. Companies not coming to an agreement would be subject to financial penalties.
Topics: Specialty, Industry Trends, Product Release, Provider, Payer
Radar On Market Access: Study Shows Growing IL-17 Use in Psoriasis
Posted by Angela Maas on Oct 15, 2019
For many years, the psoriasis treatment landscape was dominated by tumor necrosis factor (TNF) inhibitors. But with the FDA's approval of three interleukin-17 (IL-17) inhibitors — as well as other drugs with different mechanisms of action — for the condition, those therapies are becoming more common among treatment regimens, AIS Health reported.
The first IL-17 inhibitor on the U.S. market was Cosentyx (secukinumab) from Novartis Pharmaceuticals Corp., which launched in 2015. The next therapy was Taltz (ixekizumab) from Eli Lilly and Co., and then on Feb. 15, 2017, the agency approved Siliq (brodalumab) from Ortho Dermatologics.
Topics: Specialty, Market Access, Product Release, Provider, Payer
Radar On Market Access: Despite Approval of New Parkinson's Drugs, Plans Still Prefer Generics
Posted by Jane Anderson on Oct 3, 2019
Although three new drugs for Parkinson's disease have been approved over the last year, plans generally are sticking with the drugs they've included on formularies for several years, most of which are generic, experts tell AIS Health.
That may change in the long term as new gene therapies that currently are in development are approved and come online. But none of those potential new treatments are close to market right now, says Mesfin Tegenu, R.Ph., president of PerformRx.
Topics: Specialty, Market Access, Product Release, Provider, Payer
Radar On Market Access: Health Plans Are Hesitant to Add New Narcolepsy Drugs to Formularies
Posted by Jane Anderson on Sep 24, 2019
Two newly approved narcolepsy medications offer novel, possibly more effective options to people for whom older medications aren't working well, but most health plans are requiring patients and providers to try generic alternatives first, AIS Health reported.
The FDA approved Jazz Pharmaceuticals' Sunosi (solriamfetol) for adults with narcolepsy or obstructive sleep apnea in March and Harmony Biosciences, LLC's Wakix (pitolisant) in August. Sunosi was launched in July, and Wakix is expected to be launched later this year.
Topics: Specialty, Market Access, Product Release, Provider, Payer
Radar On Market Access: New Solutions to Finance High-Cost Treatments May Raise New Questions
Posted by Leslie Small on Sep 17, 2019
With concerns mounting about how health plan sponsors will pay for breakthrough treatments with ultra-high price tags, some major insurers are offering up new solutions aimed at easing that burden, AIS Health reported.
Cigna Corp. "appears at the forefront" of initiatives to cope with super-high-cost drugs, as Citi analyst Ralph Giacobbe puts it, given that the firm recently introduced a new solution that would help clients pay for and manage two gene therapies: Luxturna and Zolgensma.
Topics: Specialty, Market Access, Product Release, Provider, Payer
While only a handful of therapies in the broader regenerative medicine/advanced therapy (RM/AT) space are available globally, a new report shows that is likely to change, as there are more than 1,000 products in the pipeline, AIS Health reported.
Topics: Specialty, Industry Trends, Product Release, Data & Analytics
The study found that, assuming a 61% discount between brand-name and generic drugs, Part D beneficiaries with prescriptions costing between $22,000 and $80,000 per year would have lower out-of-pocket spending if they use brand-name drugs over a generic, AIS Health reported.
Topics: Industry Trends, Product Release, Data & Analytics
One criticism of the model is that providers' costs are compared with targeted costs that are based partly on their spending from 2012 to 2015, the OCM baseline period. When the actual costs come in below the targeted costs, that earns providers a performance-based payment. But with so many costly oncology therapies launching after the baseline period, this is making it hard for providers to gain a performance-based payment, AIS Health reported.
Topics: Industry Trends, Product Release, Data & Analytics