Drug Coverage

SIGA indicated that $5.1 million of oral Tpoxx is targeted for delivery in 2022.

All plans have $0 copay options for select medications purchased through preferred home delivery.

Humana’s 2023 Medicare pharmacy benefits updates include $0 copays, simplified access to prescriptions and Veteran’s focused-plans that add pharmacy benefits.

The retailer indicated that Express Scripts’ drug pricing model is unstainable for Kroger and its customers.

A new formulary design will be offered on the Value Script and Value Plus plans; it will contain medications used to treat diabetes and will cost only $11 per 30-day supply.

Jing Yang from IQVIA discusses how national payers are using formulary exclusions for oncology therapeutics.

In 2021, patients in the United States received 6.4 billion prescriptions, 91% of which were generic and biosimilar medicines.

Carl Black, pharmacist-in-charge at Optum Rx, talks about how the PBM has decreased dispensed opioids by 62% since 2018.

Rightway offers access to generic drugs offered by Cost Plus Drug through its mobile app.

But researchers found that only a small percentage of plans use available real-world evidence studies and economic evaluations in their coverage policies.

An Avalere review finds that the proportion of generic drugs covered on lower tiers (with generally lower out-of-pocket costs for patients) in Part D plans have decreased.

Hospitalization, disability, having private high-deductible, Medicare Advantage, or no coverage were risk factors associated with medical debt.

Approved in May 2022, Tibsovo is the first therapy targeting cancer metabolism for older patients with newly diagnosed IDH1-mutated acute myeloid leukemia.

The additions include apps to help people better manage their sleep issues, anxiety, alcohol and opioid use disorders, and inflammatory conditions.

Jeffrey A. Shaman, Ph.D., chief science officer at Coriell Life Sciences, talked about how pharmacogenomics can inform medication management.

Kali Panagos, Pharm.D., at ARMSRx, discusses the growing trend of copay assistance programs and alternative funding solutions that can help provide access to expensive specialty therapies.

Because of a generic is now available, Toviaz has been removed and up-tiered on Prime’s Medicare formularies.

Prime Therapeutics’ predictive model was able to identify members with high breast cancer pharmacy and medical claims to help clients better manage drug spend.

PSG’s latest Artemetrx specialty spend report finds that, as with 2020, claim utilization continues to drive the trend.

Ryaltris is a fixed-dose combination therapy that provides relief for both nasal and ocular symptoms of seasonal allergic rhinitis in a nasal spray.

The direct-to-consumer pharmacy also added 13 new products, and now carries almost 1,000 medications.

Survey participants said their drug costs have gone up and almost a third had trouble paying for food and housing because of high drug costs.

Hyftor was approved in April 2022 to treat patients with the rare disease facial angiofibroma associated with tuberous sclerosis complex.

Payer coverage and the prior authorization process continue to be barriers for the adoption of biosimilars, according to a new Vizient survey.

The PBM is removing four products and adding one product back to its standard control formulary.

Out-of-pocket costs decreased for those with insurance but rose for those without insurance, finds RAND study.

The rate reflects a continued trend toward moderation of the overall increase in drug prices.

Shabbir J. Imber Safdar, executive director, Partnership for Safe Medicines, talks about efforts to address counterfeit drugs in the U.S. supply chain.

Sean Dickson of West Health Policy Center discusses Reuters' analysis of drug launch prices.

A clinical trial showed Dyanavel XR tablets were bioequivalent to the extended-release oral suspension formulation of Dyanavel.