Formulary Watch |

Mark Campbell, Pharm.D., RxBenefits’ senior vice president of clinical solutions, talks about how Medicare’s drug price negotiations could have a ripple effect on pharmaceutical company innovation and prices on the commercial side.

ICER has weighed in on two of the 10 drugs selected for negotiations: Eliquis and Xarelto, which are among Medicare Part D’s highest spending drugs.

Once Medicare’s negotiated price for prescription drugs goes into effect, payers have more of an incentive to steer patients to lower-cost alternatives.

Aetna, Cigna, Humana, United Healthcare — some of the largest providers of Medicare Advantage plans — have released updates to prescription drug programs.

The recent study also found that Jardiance for patients with heart failure with preserved ejection fraction could be cost-effective if discounted by 29%.

Exxua is approved to treat adults with major depressive disorder, but its labeling does not contain warnings about sexual function or weight gain.

ICER adds a more formal process to evaluate the diversity of clinical trials and an assessment of a product’s impact on patient and caregiver productivity. ICER also plans to evaluate how newer methods — which would consider the change of a drug’s price over time and disease severity — can be applied to its value assessment.

Developing novel drugs to treat cancer remains a strong focus for drug developers. Several first-in-class therapies have become available over the last few months.

Non-White patients who used copay cards were significantly more likely to encounter copay adjustment programs, such copay accumulators and maximizers, compared with their White counterparts.

An analysis from 3 Axis has found that PBMs control how much pharmacies are reimbursed. This can vary significantly depending on the PBM contracts with insurers, creating a system with large inconsistencies in the prices that consumers pay for both generics and branded products.

The FDA has requested an additional study. ARS Pharmaceuticals plans to appeal the decision.