Drug Coverage

Effective October 1, 2021, CMS will reimburse for the infusion product when dispensed in the outpatient setting.

Regeneron also announced an expanded contract with the U.S. government for the purchase of additional doses of REGEN-COV.

The plan will cover administration of the booster for those with cancer or who are immunocompromised.

Alinia and Sutent have been removed from the drug lists because of the introduction of generic therapies.

Real-world data show Erleada prolonged survival in both metastatic and non-metastatic castration-sensitive prostate cancer.

Investigators found patients with COPD taking Anoro Ellipta had low overall on-treatment exacerbation rates, which can reduce medical costs due to increased adherence to therapy.

ICER’s updated analysis uses observational, real-world data for three therapies — Takhzyro, Haegarda, and Cinryze.

American Academy of Sleep Medicine’s guideline recommends Wakix to treat excessive daytime sleepiness and cataplexy in adults with narcolepsy.

Florida’s First Choice Neurology has provided Aduhelm to patients through the Biogen access program.

Bluebook Rx is a new solution that helps employers and plan sponsors better understand and optimize their prescription drug spending.

ICER’s policy recommendations suggest payers establish step therapy with less expensive systemic agents to allow patients and clinicians to choose from multiple options.

The liquid therapy to treat hypothyroidism now comes in 15 different dosage strengths in single-use packaging.

The therapy is the first approved for patients with tumors associated with von Hippel-Lindau disease.

The report found that mavacamten offers benefits but was above the threshold of $150,000 per quality-adjusted life-years.

These results can be used to inform health care decisions, but investigators caution there hasn’t been head-to-head trials of the two therapies.

Including patients in the decision-making process, the authors said, is an important component of patient-centered health care.

The move, effective July 15, was the result of a generic now being available.

The multiple myeloma therapy now has a permanent J code under Medicare Part B.

All stakeholders together incur about $93.3 billion in costs for implementing, contesting, and navigating drug utilization management.

The potassium-lowering agent was associated with a 20% relative reduction in costs related to outpatient, inpatient, and emergency department visits.

Four products on the preferred list this year will be excluded next year.

The VA recommends against offering this agent to patients with Alzheimer’s dementia, mild or otherwise.

The program and proposed integrations could produce $15 million in savings annually.

The graft-versus-host disease therapy has also been added to NCCN Guidelines.

Previously patients administered as two, 75-mg shots. Now they can inject a single 150-mg dose.

Current drug shortages based on FDA data, prepared by Formulary Watch.

A single application targets the infection without entering the circulatory system.

The sickle cell disease therapy will now be on the Preferred Drug List.

Drugs that provide only incremental benefit may not be included on clinical pathways.

The findings were similar in people with or without diabetes.