Formulary Watch |

Formulary Watch covers formularies, pharmacy benefit management companies, drug approvals, and other matters related to medications, their prices and insurance coverage.

Editorial Contact: Denise Myshko: dmyshko@mjhlifesciences.com

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BLA Accepted for Melanoma Combination Therapy, RP1 and Nivolumab
BLA Accepted for Melanoma Combination Therapy, RP1 and Nivolumab
January 22, 2025
The investigational advanced melanoma combination therapy consisting of RP1 and nivolumab have a PDUFA action date of July 22, 2025.
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Trump Impact on Medicare Drug Price Negotiations Uncertain
Trump Impact on Medicare Drug Price Negotiations Uncertain
January 22, 2025
Trump has reversed some of President Biden’s initiatives, including $2 monthly out-of-pocket cap on some generics and experimental pricing models for gene therapies. But so far the healthcare elements of the Inflation Reduction Act remain unchanged.
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FDA Approves Metastatic Breast Cancer Drug, Datroway
FDA Approves Metastatic Breast Cancer Drug, Datroway
January 20, 2025
Datroway reduced disease progression by 37% when compared with chemotherapy.
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UnitedHealth Vows to Reduce Prior Authorization Burden
UnitedHealth Vows to Reduce Prior Authorization Burden
January 20, 2025
CEO Andrew Witty promised that UnitedHealthcare would work to speed up turnaround times for approval of some procedures and services in Medicare Advantage plans.
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CMS Releases Next List for Drug Price Negotiation
CMS Releases Next List for Drug Price Negotiation
January 17, 2025
Ozempic, Rybelsus and Wegovy top the list of the newest drugs selected for Medicare Part D price negotiation, part of the Inflation Reduction Act.
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FDA Approves Lilly’s Omvoh for Crohn's Disease, Second Indication
FDA Approves Lilly’s Omvoh for Crohn's Disease, Second Indication
January 16, 2025
More than half (53%) of patients reached remission after one year of Omvoh treatment and 46% experienced healing of the intestinal tract, when compared to placebo.
UnitedHealth Group CEO Andrew Witty Defends PBMs
UnitedHealth Group CEO Andrew Witty Defends PBMs
UnitedHealth Group CEO Andrew Witty Defends PBMs
January 16, 2025
In an investor call, Andrew Witty promised full transparency and 100% pass-through rebates for prescription drugs by 2028.
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FDA Accepts BLA for Leqembi Autoinjector
FDA Accepts BLA for Leqembi Autoinjector
January 14, 2025
If approved, subcutaneous autoinjector Leqembi will be the only Alzheimer's medication that can be administered at home. The FDA has set a goal date of Aug. 31, 2025.
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New FTC Report: PBMs Mark Up Specialty Generic Drugs
New FTC Report: PBMs Mark Up Specialty Generic Drugs
January 14, 2025
The Federal Trade Commission suggests that PBMs profit from specialty generic drugs such as those for cancer and HIV and steer patients to their own pharmacies.
FDA to Hold Ad Comm Meeting for Rexulti in PTSD
FDA to Hold Ad Comm Meeting for Rexulti in PTSD
FDA to Hold Ad Comm Meeting for Rexulti in PTSD
January 10, 2025
The target action date for Rexulti in combination with sertraline to treat patients with post-traumatic stress disorder, originally planned for Feb. 8, 2025, will be delayed.
Bayer Submits Supplemental NDA for Kerendia in Heart Failure
Bayer Submits Supplemental NDA for Kerendia in Heart Failure
Bayer Submits Supplemental NDA for Kerendia in Heart Failure
January 10, 2025
Kerenida is currently approved to slow the progression of chronic kidney disease associated with type 2 diabetes.
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FDA Requires Guillain-Barré Warning for Abrysvo and Arexvy
FDA Requires Guillain-Barré Warning for Abrysvo and Arexvy
January 9, 2025
Regulators say, however, the benefits of vaccination with Abrysvo and Arexvy in preventing respiratory syncytial virus continue to outweigh their risks.
IBX Excludes Coverage of Drugs with Accelerated Approvals for 18 Months
IBX Excludes Coverage of Drugs with Accelerated Approvals for 18 Months
IBX Excludes Coverage of Drugs with Accelerated Approvals for 18 Months
January 7, 2025
Effective Jan. 1, 2025, Independence Blue Cross has begun excluding coverage for 18 months for therapies — but not cancer drugs — that have an accelerated approval based on a surrogate endpoint.
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Capricor Completes BLA for Deramiocel for Duchenne Cardiomyopathy
Capricor Completes BLA for Deramiocel for Duchenne Cardiomyopathy
January 3, 2025
Deramiocel is a cell therapy that has healing effects in muscle cells. If approved, deramiocel would be a once-quarterly therapy and the first specifically approved for cardiomyopathy in patients with Duchenne muscular dystrophy.
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FDA Sets Goal Date for Ovarian Cancer Combination
FDA Sets Goal Date for Ovarian Cancer Combination
January 2, 2025
FDA officials have set a review date of June 30, 2025, to review avutometinib in combination with defactinib to treat patients with recurrent low-grade serous ovarian cancer.
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FDA Issues Complete Response for Zynquista in Type 1 Diabetes
FDA Issues Complete Response for Zynquista in Type 1 Diabetes
January 1, 2025
In November 2024, a regulatory advisory board said the benefits of Zynquista does not outweigh the risks in adults with type 1 diabetes and chronic kidney disease.
FDA Approves Subcutaneous Opdivo to Treat Solid Tumors
FDA Approves Subcutaneous Opdivo to Treat Solid Tumors
FDA Approves Subcutaneous Opdivo to Treat Solid Tumors
December 28, 2024
Opdivo Qvantig is the first subcutaneously administered PD-1 inhibitor approved by the FDA. It is expected to be available in early January 2025 and will be priced at parity to the IV version of Opdivo.
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FDA Approves First Once-Daily Generic of Victoza for Type 2 Diabetes
FDA Approves First Once-Daily Generic of Victoza for Type 2 Diabetes
December 24, 2024
Liraglutide injection is now approved for adult and pediatric patients ages 10 and up, proving another option amid the GLP-1 shortage.
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FDA Approves Zepbound for Obese Adults with Sleep Apnea
FDA Approves Zepbound for Obese Adults with Sleep Apnea
December 23, 2024
Up to half of obstructive sleep apnea patients taking Zepbound had no symptoms after one year of treatment, averaging 25 fewer breathing interruptions per hour.
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Savara Begins Rolling BLA for Molbreevi for Rare Lung Disease
Savara Begins Rolling BLA for Molbreevi for Rare Lung Disease
December 20, 2024
If approved, Molbreevi could be the first FDA-approved treatment for patients with autoimmune pulmonary alveolar proteinosis, a rare lung disease.
 FDA Approves Tryngolza for Rare Triglyceride Disease
 FDA Approves Tryngolza for Rare Triglyceride Disease
FDA Approves Tryngolza for Rare Triglyceride Disease
December 20, 2024
Tryngolza is once-monthly, subcutaneous RNA-targeted therapy and is expected to be available by the end of the year with a price of $595,000.
ICER Finds Insurers Struggled to Provide Fair Access for Obesity Drugs
ICER Finds Insurers Struggled to Provide Fair Access for Obesity Drugs
ICER Finds Insurers Struggled to Provide Fair Access for Obesity Drugs
December 19, 2024
The Institute for Clinical and Economic Review assessed the formularies of 11 payers, covering 57 million people, to determine access for drugs that the organization had reviewed in 2022 for cost-effectiveness.
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FDA Approves Seventh Stelara Biosimilar, Steqeyma
FDA Approves Seventh Stelara Biosimilar, Steqeyma
December 18, 2024
Originally approved in 2009, Stelara patents began expiring in 2023, leading to an influx of recent biosimilars.
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FDA Adds Boxed Warning to Veozah Label
FDA Adds Boxed Warning to Veozah Label
December 18, 2024
The boxed warning follows a safety warning the FDA issued in September about the risk of liver injury from the use of Veozah to treat hot flashes.
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