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Pharmacy Briefing | November 2022

4 January 2023

Highlights

  • Tzield (teplizumab-mzwv) is approved as a first-in-class therapy to delay the onset of type 1 diabetes.
  • Kaiser Family Foundation (KFF) analyzes impact of possible COVID-19 vaccine commercialization
  • IQVIA report explores the impact of pharmacy discount cards
  • Amgen publishes 2022 Biosimilar Trends Report

FDA approvals and launches

  • Tzield (teplizumab-mzwv) is approved as a first-in-class therapy to delay the onset of type 1 diabetes.
  • Hemgenix (etranacogene dezaparvovec) is approved as a gene therapy to treat hemophilia B, costs $3.5 million per treatment.
  • Furoscix (furosemide) is approved as a subcutaneously delivered product used to treat chronic heart failure.

News

Kaiser Family Foundation (KFF) analyzes impact of possible COVID-19 vaccine commercialization

  • It is likely that the cost burden of COVID-19 vaccines will shift to commercial payers in 2023.
  • Pfizer has suggested a list price of between $110 and $130 per dose while Moderna has suggested a list price of between $82 and $100 per dose.
    • Per-dose costs for commercial payers are likely to be significantly higher than for federally-purchased doses.

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IQVIA report explores the impact of pharmacy discount cards

  • The research group estimates that discount cards were used in 5.4% of all prescription adjudications in 2021.
  • GoodRx was estimated to be the largest vendor in this space, with 46% of the market share by volume.

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Amgen publishes 2022 Biosimilar Trends Report

  • The manufacturer estimates that, over the past six years, there has been $21 billion in savings for drug classes with biosimilar competition.
  • In the EU, Humira’s market share dropped to an estimated 34% after roughly four years of biosimilar availability.
  • Amgen received the first FDA approval for a Humira biosimilar with Amjevita, which has an anticipated launch sometime in 2023.

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National Pharmaceutical Council (NPC) president discusses real-world impact of 340b program

  • The organization’s president cites a need for “ferreting out the profiteering the law has enabled” and references a study which “found that just 1.4% of 340B-eligible claims show that discounts were actually given to patients.”

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Pharmacy retailers agree to billions in opioid settlements

  • Retailers such as CVS and Walgreens are alleged to have mishandled prescriptions for opioid products, contributing to the nationwide epidemic.
  • Several manufacturers implicated in the epidemic have also agreed to similar settlements.

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Elixir releases 2023 formulary changes

  • A prior authorization requirement will be added to the GLP-1 drug class, in part, to ensure appropriate use for both diabetes and weight-loss.
  • Elixir’s non-essential drug (NED) program will add 17 products including certain forms of diabetes drug metformin and muscle-relaxant baclofen.

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TRICARE’s PBM, Express Scripts, removes thousands of pharmacies from pharmacy network

  • Approximately 27% of pharmacies in the TRICARE network were removed; most of these pharmacies were independent pharmacies.
  • Removals may disproportionately affect patients living in rural areas of the country.
  • Kroger pharmacies will also no longer be part of the TRICARE retail pharmacy network starting January 1, 2023.

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Mark Cuban Cost Plus Drugs Company partners with EmsanaRx, Rightway Healthcare, and Capital Blue Cross

  • The collaboration with EmsanaRx, Rightway Healthcare, two PBMs, and Capital Blue Cross, a health plan, will help the company increase its footprint in the industry.

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HHS’s Assistant Secretary for Planning and Evaluation (ASPE) publishes Trends in Prescription Drug spending, 2016-2021

  • Steady increases in prescription drug spending were driven mainly by increases in spending per prescription as opposed to increases in utilization.
  • The report also discusses the impact of the Inflation Reduction Act (IRA) on the pharmaceutical industry.

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Evernorth launches Specialty Adherence Protection program

  • The program aims to target specialty drug spend as an opportunity to improve patient adherence and reduce waste.

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