Empagliflozin (Jardiance) and another SGLT2 inhibitor, canagliflozin (Invokana) have been competing aggressively; both have clinical trial results showing cardiovascular benefits.
The pharmacy benefits manager (PBM) Prime Therapeutics, owned by 18 Blue Cross Blue Shield plans or subsidiaries, announced it will pay for the therapy empagliflozin (Jardiance) under an outcomes-based contract with Boehringer-Ingelheim. The companies announced the deal in a statement.
Empagliflozin, first approved to treat type 2 diabetes (T2D), was the first such therapy found to have cardiovascular (CV) benefits and the first to have an FDA indication to reduce CV mortality. Since then, a competitor in the same class of sodium glucose co-transporter-2 (SGLT2) inhibitors, canagliflozin (Invokana) by Janssen, was also found to have CV benefits; the drug sponsor is also seeking a CV indication from FDA.
Competition between the 2 drugs is fierce. Going into 2018, CVS Caremark removed empagliflozin in favor of canagliflozin, following the announcement of the latter drug's CV results in June 2017.
Two other SGLT2 inhibitors also have FDA approval: dapagliflozin (Farxiga) from AstraZeneca; and ertugliflozin (Steglatro) from Merck and Pfizer, which was approved along with combinations at the end of 2017.
“Because diabetes affects nearly 10% of the US population, Prime actively works to find solutions that can improve our members’ health outcome and control the overall costs of diabetes,” said Jonathan Gavras, MD, chief medical officer at Prime. He said the agreement would allow for the collection of key data beyond pharmacy claims and insights gained would “help drive the greatest value from the treatment.”
Alec Mahmood, chief financial officer at Prime, said the contract was one of several in recent months that sought to align incentives among payers, manufacturers, providers, and health plan members to make sure “drugs work as they are intended.”