FormularyWatch

Optum Rx's new cost-based program uses an internal algorithm that leverages multiple available industry data sources, such as NADAC and PAC, to inform reimbursement. https://lnkd.in/eZDfTQDr

Lumicera Health Services, Navitus’ specialty pharmacy, has made a deal with Teva to offer an unbranded biosimilar that they estimate will save $112,000 and $336,000 per patient per year. Navitus will remove Stelara from formulary on July 1, 2025. https://lnkd.in/emuTw9WX

The new bill would also require state Medicaid programs to report National Average Drug Acquisition Costs (NADAC) as a way to increase transparency in drug pricing. https://lnkd.in/ek39_EWS

The FDA?has approved the first generics of Xarelto (rivaroxaban) 2.5 mg tablets, an anticoagulant to prevent deep vein thrombosis in adults with peripheral artery disease and to reduce the risk of major cardiovascular events adults with coronary artery disease. https://lnkd.in/eRWjKaf6

Of the states that do provide coverage for JAK inhibitors used to treat patients with alopecia, researchers found that prior authorization is required by an overwhelming majority of plans, according to an analysis presented at the American Academy of Dermatology annual meeting. https://lnkd.in/eVP2xaui

NovoCare Pharmacy will provide all dose strengths of Wegovy at a reduced cost of $499 per month for cash-paying patients without insurance. https://lnkd.in/eskYEkgb

The Institute for Clinical and Economic Review has prepared a special report on Trelegy and Breo, two therapies that treat patients with chronic obstructive pulmonary disease that are part of CMS's drug price negotiation program. https://lnkd.in/e6-k2Kjw

The FDA had approved Otulfi in September 2024 to treat Crohn’s disease, ulcerative colitis, psoriasis and active psoriatic arthritis. The FDA has also granted a provisional determination of interchangeability for Otulfi. https://lnkd.in/eXe8MCwz

MedImpact Healthcare Systems has selected two biosimilar alternatives to Stelara — Selarsdi and Yesintek. Both launched this month at prices that are 85% and 90% off the cost of Stelara. https://lnkd.in/emNAYaqS

Just as quickly as it was announced, Blue Cross Blue Shield of Michigan dropped a step therapy requirement for the oncology drug Darzalex Faspro. The plan said said it is evaluating any potential updates to the coverage process for Darzalex Faspro and there are no changes at this time. https://lnkd.in/edwB8aks