Continuous Glucose Monitoring (CGM) systems offer either real-time monitoring of blood glucose levels (Dexcom G6®, Freestyle Libre 3®, Guardian Connect®, Eversense E3®) or intermittent scanned monitoring, often referred to as a flash CGM (Freestyle Libre 2® and Libre 14 Day® devices). We are beginning to see coverage of CGM devices migrate toward the pharmacy benefit instead of only the medical benefit. This is an effort to improve patient access and corresponds with the transition of tubeless insulin pump products that integrate with CGM devices to the pharmacy benefit. The Centers for Medicare & Medicaid Services (CMS) continue to cover CGM devices under the medical benefit Part B. There are four major manufacturers of CGM devices: Abbott Laboratories (FreeStyle®), Dexcom (Dexcom G6®), Medtronic (Guardian Connect®), and Ascensia Diabetes Care (Eversense E3®). Depending on the product and type of technology, the wholesale acquisition cost can range from as little as $122 per month up to approximately $700 per month for the device components.
https://www.diabeteseducator.org/docs/default-source/practice/educator-tools/role_cgm_12272021.pdf
On November 22, 2022, the FDA approved CSL Behring’s Hemgenix, a gene therapy for treatment of adults with hemophilia B (congenital Factor IX deficiency) who currently use Factor IX prophylaxis therapy, or have current or historical life-threatening hemorrhage, or have repeated, serious spontaneous bleeding episodes. Although hemophilia B is a rare condition, intravenous infusions to treat hemophilia B range from $550,000-$750,000 annually. Hemgenix is administered as a single dose intravenous infusion. Hemgenix will cost approximately $3.5 million, which will make it the most expensive medicine approved to date in the world for a single-use therapy.
Insulin is a standard of care for the treatment of diabetes and accounts for a large amount of sales in the diabetic drug therapy space. There is often confusion on when an insulin product can be substituted by a pharmacist. Unbranded insulin products are packaged and marketed without a brand-name under the same Biologics License Application as the brand-name product and are considered equivalent and interchangeable. This includes Novolog®/ Insulin Aspart (unbranded), Humalog®/ Insulin Lispro (unbranded), and Semglee (yfgn)®/Insulin Glargine (yfgn) (unbranded). …
On February 17, 2022, the U.S. Advisory Committee on Immunization Practices' (ACIP) recommended vaccination schedule for U.S. adults 19 years of age and older was shared with some important changes to zoster (shingles), pneumococcal,…
The US Government has launched a website that allows for every home in the US to order four (4) free at-home COVID-19 tests.…
