- This Week in Managed Care: November 23, 2016 (ajmc.com)
Sara Belanger with The American Journal of Managed Care. Welcome to This Week in Managed Care from the Managed Markets News Network
- High prices for some leukemia drugs will make them less cost-effective (statnews.com)
Pills used to treat a form of leukemia may be more effective and convenient than chemotherapy, but a new study suggests pricing is projected to raise the annual cost of care by 590 percent – to more than $5 billion – over the next decade, straining payer budgets and causing financial hardship for patients...Here’s why: The number of people in the US living with chronic lymphocytic leukemia, which is a rare blood and bone marrow disease, is forecast to reach 199,000 in 2025, up from 128,000 five years ago, thanks to more effective treatment. But a higher-priced pill, which is used as a first-line therapy and taken indefinitely, will also outpace the cost of chemotherapy, which has a fixed duration for treatment...As a result, the annual cost of managing the disease is projected to rise to $5.1 billion by 2025, up from $740,000 million in 2011, based on current pricing. And the cost of treating each patient for a lifetime is expected to increase 310 percent, to $604,000 from $147,000 during that same period. And for Medicare patients, the out-of-pocket cost is forecast to jump 520 percent, to $57,000 from $9,200.
- Two biosimilars approved, but litigation delays launch (pharmacytoday.org)
FDA recently approved the first biosimilars for adalimumab (Humira—AbbVie) and etanercept (Enbrel—Amgen), known as adalimumab-atto (Amjevita—Amgen) and etanercept-szzs (Erelzi—Sandoz), respectively. These approvals came after unanimous votes of support by FDA’s Arthritis Advisory Committee in July. Unfortunately, the launch of both biosimilar products will be delayed because the manufacturers of the reference products are involved in litigation against biosimilar manufacturers for patent infringement...A recent meta-analysis...suggest these products have nearly identical pharmacokinetics, efficacy, and toxicity…Although the trials cited by this meta-analysis involved limited numbers of patients, there is no reason to suspect these biosimilars will not be nearly identical to their reference product...
- Software as a Drug (thehealthcareblog.com)
What if your spouse were a borderline Type 2 diabetic? If you had the money, you could hire someone to follow her or him around the clock, sort of like a glorified personal trainer. Your spouse would make sure he or she took a daily mile-long walk, did some weight training to build muscle mass and would stop you from eating ice cream or cake or drinking a glass of wine...A good idea – but too expensive, right?...It doesn’t have to be, because a new and highly efficient modality – digital therapeutics – has entered the picture. Commonly referred to as “software as a drug,” digital therapeutics relies on software to similarly deter your spouse from becoming diabetic – in tandem with online coaches, electronic messages and the use of social networks...Most digital health companies deploy software modules as an enhancement, or even a substitute, to a prescription drug. They are affordable and effective and poised to become a critical component of digital health, thereby substantially improving the efficiency of American healthcare. Digital therapeutics is already roughly a $500 million market and positioned to balloon into a $6 billion market…
- Pharmacy Week in Review: November 23, 2016 (pharmacytimes.com)
Kelly Walsh, PTNN. This weekly video program provides our readers with an in-depth review of the latest news, product approvals, FDA rulings and more.
- NYPD Union Goes After Drug Prices Amid DOJ Pharma Probe (bloomberg.com)
As the generic drug industry braces for charges from a two-year U.S. Justice Department antitrust investigation, a union representing the sergeants of the New York Police Department is attempting to hit some companies with civil penalties as well...A pair of lawsuits filed by the Sergeants Benevolent Association Health & Welfare Fund against two groups of drugmakers, which include...Novartis AG’s generic drug unit,...Perrigo Co., India’s Wockhardt Ltd. and Taro Pharmaceutical Industries Ltd., allege the companies colluded to raise prices on two dermatological creams as much as 1,000 percent…U.S. pharma sector is now facing sharp scrutiny on pricing, including a sweeping Justice Department probe. That antitrust investigation spanning companies from around the world is examining whether some executives agreed with one another to raise prices on generic medicines in the U.S...
- Launching a drug? Be prepared to show it’s cost-effective up front, consultant says (fiercepharma.com)
On the heels of Trinity Partners’ first medicines index, president John Corcoran said the biopharma industry can expect a continued focus on specialty drugs and drastically different drug launches in the years to come...Gone are the days of "brute force marketing" propelling new drugs to big sales...with concepts such as "real-world evidence," "outcomes," "cost effectiveness," and "health economics" expected to play a bigger role than ever moving forward...drugmakers who place lofty stickers on their meds will increasingly be tasked with defending their high prices. These days, cost effectiveness concepts are "much more evident in the conversation now than at any point…"
- Mylan refuses to testify at Senate hearing about EpiPen rebates to Medicaid (statnews.com)
In a move that angered a key Senate lawmaker, Mylan Pharmaceuticals has declined to testify at a planned Nov. 30 Senate hearing to review a $465 million settlement the drug maker purportedly reached with the US Department of Justice for shortchanging Medicaid...In a letter to...the Senate Judiciary Committee...Mylan explained the company will not appear for three reasons – the “stated focus of the hearing,” because the hearing involves a “pending matter,” because both the Justice Department and the Centers for Medicare & Medicaid Services have already said they will not send officials to testify...(Senator) Grassley (chairs the Senate Judiciary Committee) responded by blasting the feds, as well as the drug maker...“The Obama Administration is dodging accountability for an expensive problem, and now a company is following its bad example,” he said in a statement. “Taxpayers have paid and [reportedly] continue to pay hundreds of millions of dollars more for the EpiPen than they have to pay. This happened because either the agencies in charge dropped the ball, the company gamed the system, or both.”
- 5 Most Expensive Medicare Drugs — and Which Companies Are Getting Rich from Them (fool.com)
Medicare spends billions of dollars each year on prescription drugs. That's not surprising. What might be surprising, though, is how much the federal healthcare program spends per patient on some of these drugs. Here are the five most expensive drugs covered by Medicare on a per-patient basis -- and which companies are making a lot of money from them.
- H.P. Acthar (corticotropin)…Medicare spent $162,371 per patient in 2015 on a drug that's been around since the 1950s -- H.P. Acthar. The drug, which is made from an extract from the pituitary glands of pigs, is used to treat several indications, including multiple sclerosis relapse and infantile spasms.
- Remodulin (treprostinil)…which treats pulmonary arterial hypertension, ranked as the second most expensive drug covered by Medicare. The average cost per patient for Remodulin in 2015 was $144,070. Unlike most of the high-cost drugs reimbursed by Medicare, the price for Remodulin didn't increase last year.
- Tyvaso (treprostinil inj)…Another pulmonary arterial hypertension treatment, Tyvaso, came in right behind Remodulin on Medicare's list of costly drugs. Medicare spent $107,489 per patient for Tyvaso in 2015.
- Provenge (sipuleucel-T)…ranks as the most expensive cancer treatment (on a per-patient basis) for Medicare. The federal program spent $95,290 per patient for the advanced prostate cancer immunotherapy last year.
- Harvoni (ledipasvir and sofosbuvir)…Medicare spent $92,847 per patient last year for Harvoni. That landed the hepatitis C drug at No. 5 on the list of most expensive drugs covered by Medicare. However, Harvoni is at the very top of the list when it comes to total spending. Medicare spent over $7 billion in 2015 for Harvoni, by far the most of any drug covered by the program.
These five most expensive drugs covered by Medicare have one surprising thing in common: None of them had big price increases last year...Another thing that most of these drugs have in common is that they play a significant role in the fortunes of the companies that sell them.
- Patient in fatal plane crash was a miner at Bald Mountain (elkodaily.com)Pilot likely saved lives in medical plane crash, Elko police say (reviewjournal.com)
The patient killed in Friday night’s fiery medical plane crash was a miner who was planning to retire soon, and the nurse was an Elko woman who got her "dream job" with American Medflight just a few weeks ago and was recently engaged to be married...They were two of four victims killed when an American Medflight plane crashed into the Barrick Gold Corp. parking lot...Also killed were the pilot...Yuji Irie; and paramedic Jake Shepherd of Utah.
- Edward Clohesey - 67, was a Spring Creek resident and a heavy equipment operator at Bald Mountain...Clohesey was experiencing chest pains and rapid heartbeat...after which the decision was made to transport him to a hospital in Utah for open heart surgery.
- Tiffany Urresti - 29, was a flight nurse who had been with American Medflight for about a month...she had worked as an emergency room nurse at Northeastern Nevada Regional Hospital before that.
- Jake Shepherd was a paramedic for Mountain West Medical Center in Tooele County, Utah.
- Yuji Irie – 63, saved hundreds of lives over a long career at American Medflight. He was based in Ely, Nevada, the toughest base for inclement weather in the American Medflight system.