Three-tier benefit cuts Rx costs without unintended consequences

The private-label biosimilar will be available at an 80% discount off Stelara. Evernorth has not released information about which company will be producing the biosimilar.

In this week's episode of Tuning Into The C-Suite podcast, MHE's Briana Contreras chatted with David Calabrese, R.Ph, MHP, who is senior vice president and chief pharmacy officer of pharmacy care services company, OptumRx. David is also a member of Managed Healthcare Executives’ Editorial Advisory Board. During the discussion, he shared the OptumRx Quarter 2 Drug Pipeline Insights Report of 2020. Some of the information shared includes the three notable drugs currently being reviewed or those that have been recently approved by the FDA. Also discussed were any interesting industry trends to watch for.

The growth of out-of-pocket and insurer/negotiated prices paralleled one another until 2016 when negotiated and insurer prices began declining

Sebetralstat would be the first oral, on-demand treatment for hereditary angioedema if approved.

The new program provides large employers with access to Capital Rx’s technology platform for claim adjudication, invoicing, and reimbursement.

MedImpact is not requiring patients currently taking Humira to switch, and all three products are on a preferred tier.