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ProAct Biosimilar Strategy Update

ProAct Biosimilar Strategy Update hero image

Although Humira will remain on ProAct’s preferred formulary at least until January 1, 2024, ProAct is continuing to monitor the biosimilar space as more Humira biosimilars launch to market this summer. The main two scenarios we are evaluating leading to January 1st include:

  1. Humira continues to remain preferred along with some of its biosimilars, considering AbbVie's ability to provide a manufacturer-specific bundle Humira, Rinvoq, and Skyrizi together, or
  2. Humira loses preferred formulary status and some of the lower cost Humira biosimilars options become preferred on ProAct’s formulary.

In both scenarios, we expect Humira plan spend to decrease in the coming years due to the introduction of competition. Based on recent settlement agreements, Stelara will be one of the next major drugs in the anti-inflammatory space to face biosimilar competition in early 2025. There are several manufacturers that may have biosimilar versions of both Humira and Stelara on the market in 2025, including Amgen and Teva, so we could see a manufacturer-specific biosimilar bundle in the future. Estimates show upwards of a 65% shift away from Stelara to biosimilars by 2027. Additional considerations for Stelara include several newer agents in the same class. These newer agents are designed to demonstrate superiority over Stelara in Crohn’s Disease, in which Stelara has the largest representation. Based on the studies' results, we could see a negative impact to Stelara utilization and transition to a newer agent.

Pharmacologic Therapy for Diabetes Mellitus

Pharmacologic Therapy for Diabetes Mellitus hero image

Drug therapy can bring a complexity to a diabetic’s healthcare and every day life as there are many different types of drugs that work in different ways to help keep blood sugar under control.…

Specialty Pharmacies Show Lower Drug Costs Compared to Other Sites of Care

Specialty Pharmacies Show Lower Drug Costs Compared to Other Sites of Care hero image

New research from America’s Health Insurance Plans (AHIP) shows the cost of medication, when administered in a hospital or physician’s office, was much higher than if that same medication was purchased directly by the patient through a specialty pharmacy. 

Some specific findings from the research include:

  • Costs per single treatment for drugs administered in hospitals were an average of $8,200 more than those for the same drug purchased through specialty pharmacies.
  • Drugs administered in physician offices were an average of $1,500 higher than for the same drugs purchased through specialty pharmacies.
  • Hospitals, on average, charged 118% more for the same drugs, compared to specialty pharmacies.
  • Physician offices, on average, charged 23% more for the same drugs, compared to specialty pharmacies.

For more information related to this research, please visit https://www.ahip.org/news/press-releases/new-research-details-prescription-drug-pricing-pain-for-patients-as-average-hospital-prices-are-8-200-higher-than-specialty-pharmacies-per-single-treatment.

First Naloxone Product Approved for Use Without a Prescription

First Naloxone Product Approved for Use Without a Prescription hero image

On March 29, 2023, the Food and Drug Administration approved the first naloxone product available without a prescription. Naloxone is a medication that rapidly reverses the effects of and is the standard treatment for opioid overdose. Emergent BioSolutions anticipates its Narcan (naloxone hydrochloride) 4 mg nasal spray will be available for consumers to purchase over-the-counter by August 2023. Pricing information has not yet been released. Currently, prescription versions will remain available through pharmacies (via standing order or co-prescription laws) and other community distribution methods.
For more information visit: https://www.fda.gov/news-events/press-announcements/fda-approves-first-over-counter-naloxone-nasal-spray

Photo Credit: Giovanni Cancemi - http://stock.adobe.com

Generic Drug Shortages Continue

Generic Drug Shortages Continue hero image

In March 2023, the U.S. Senate Committee on Homeland Security and Governmental Affairs released a document supporting findings that drug shortages increased by almost 30% between 2021 and 2022. The number of active drug shortages in the U.S. reached a peak of 295 at the end of 2022. In just the last 60 days, two generic manufacturers have left the generic drug market with Akorn Pharmaceuticals filing for Chapter 7 bankruptcy and Eagle Pharmaceuticals withdrawing its only generic product from the market. Furthermore, increases in telehealth services for attention-deficit/hyperactivity disorder (ADHD) have only expanded the shortage of products like immediate-release (IR) amphetamine mixed salts to methylphenidate. If this trend of generic manufacturers leaving the market continues, we could see less opportunity for discounts and increased future drug shortages, leading to an increase in usage of more costly brand name medications.

https://www.hsgac.senate.gov/wp-content/uploads/Drug-Shortages-HSGAC-Majority-Staff-Report-2023-03-22.pdf

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