Xyplorer Scripts Express Members4/13/2021
The 16 who said they were likely or significantly likely to prefer Beovu over Eylea said they would need a 27 discount to do so.
Xyplorer Scripts Express Members Plus Three ContinuousCVS Caremark, which says its focusing on brands that have experienced hyperinflation, will exclude more than 30 medications plus three continuous glucose monitors.And UnitedHealth Group PBM OptumRx, which discussed changes to its formulary in a recent webinar, will exclude several popular medications for asthma, fibromyalgia and contraception.In addition, another factor could be aligning their purchasing strategies for their pharmacies to the formulary alignment to ensure financial success across the board.Theyre taking a harder-line approach on these items all PBMs are doing that. It will substitute generic versions, Michael Hunter, Pharm. D., pharmacy management consultant at Milliman, Inc., tells AIS Health. For example, OptumRx will exclude AbbVie Inc.s branded thyroid replacement hormone Synthroid (levothyroxine) beginning in 2020. PBMs typically cover multiple iterations of thyroid hormone replacement, he says, but OptumRx is now clarifying coverage and excluding Synthroid. From a pharmaceutical perspective, I know a lot of physicians and patients prefer the brand. ![]() It achieved this by applying strategies such as hyperinflation drug removals, the company says. CVS Caremark says that medication cost an average of 617.17 for a 30-day supply, while substituting immediate release metformin costs 3.80 on average for a 30-day supply. Since chlorzoxazone costs 2,902.64 on average for a 30-day supply and cyclobenzaprine costs 1.76, the average savings from this strategy is 2,901, according to the company. He adds that these exclusion lists have been in place for several years now, and payers have grown to anticipate them and expect them. Some appreciate the due diligence of tight management, he says, while others may get some pushback from plan members. ![]() You have to look at the disruption in addition to the savings, and make sure the performance aligns with the contract. This can involve various financial strategies, including rebates and mail order incentives, he says. Specialty pharmacy costs are taking up a rapidly increasing percentage of overall prescription budgets, and nearly two-thirds of the products expected to be launched over the next two years are specialty drugs. In some cases the brand name product is excluded, while in others it is not, he says, adding that PBMs likely will solidify their strategies as more biosimilars come to market. One of the big ones will be a biosimilar for Humira adalimumab, but thats not coming until 2023, he says. The intravitreal injection will compete in a fairly crowded anti-vascular endothelial growth factor (anti-VEGF) market that is led by Eylea (aflibercept) from Regeneron Pharmaceuticals, Inc. Research from Zitter Insights shows that its likely the drugs will be managed at parity. These respondents said the average discount, including rebates, that they would need to prefer Eylea over Beovu is 29.
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