Formulary Watch |

Medicare and Medicaid spent more than $18 billion on drugs without verified clinical benefit.

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

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

If approved, valoctocogene roxaparvovec would be the first commercially-available gene therapy in the United States for the treatment of severe hemophilia A.

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

Now with the brand name Relyvrio, the new therapy should be available within four to six weeks. It will have a wholesale acquisition cost of $158,000 per year.

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.

Bebtelovimab is available under an emergency use authorization, and the HHS is making doses available to those who are uninsured and underinsured.

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

Committee members felt the data on overall survival for patients treated with Copiktra was difficult to interpret, and the therapy was associated with a higher risk of serious side effects and deaths compared with Kesimpta.

While some patients with relapsed or refractory multiple myeloma saw a benefit in a confirmatory trial, the main issue concerning the committee members was a high rate of death in the study.

RBX2660 — now with the brand name Rebyota — is a potential first-in-class microbiota-based live biotherapeutic that aims to reduce recurrent C. difficile infection.

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.

Several concerns factored into the decision, including a low overall response rate and high rate of adverse events, a dose that was not optimized and a confirmatory trial that will not likely see results until 2026.