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This Week in Managed Care: March 16, 2018


This week, the top managed care stories included Sanofi offering a deal to payers for its cholesterol drug; a “right-to-try” bill is defeated in the House; and a forum of oncology pharmacists discusses “health insurance” versus “healthcare.”

Sanofi offers a deal to payers for its cholesterol drug, a “right-to-try” bill is defeated in the House, and a forum of oncology pharmacists discusses “health insurance” versus “healthcare.”

Welcome to This Week in Managed Care, I’m Kelly Davio.

Talks With Payers Begin to Jump Start Praluent Sales

Sanofi and Regeneron have offered to drop the price of its PCSK9 inhibitor if payers end the barriers that doctors and patients have experienced.

The announcement came after results presented at the annual meeting of the American College of Cardiology (ACC) showed that alirocumab, sold as Praluent, cut the overall risk of death by 29% for patients with LDL cholesterol levels above 100 milligrams per deciliter, which includes those with a genetic condition that causes high cholesterol.

The Institute for Clinical and Economic Review (ICER) updated its report on alirocumab, saying it is worth $4450 to $8000 for certain patients. In a statement to The American Journal of Managed Care®, Sanofi’s Sheldon Koenig said ICER’s report would be the basis for talks with payers:

“Beginning this week, Sanofi and Regeneron will meet with US health plans to discuss potential net price adjustments for those that agree to provide straight forward access for high-risk patients. The companies also plan to work with cardiology healthcare professionals to define best practices in terms of reducing barriers to access in order to ensure that patients in need have their prescriptions filled quickly and efficiently.”

During an ACC press conference, Dr. Valetin Fuster of Mount Sinai, editor of the Journal of the American College of Cardiology, said in response to a question from AJMC® that the prior approval process was a deliberative attempt to make patients ineligible for PCSK9 inhibitors.

For more from the ACC meeting, visit ajmc.com.

"Right-to-Try" Legislation Defeated

Members of the House of Representatives voted down a revamped “Right to Try” bill this week, after some questioned whether it was necessary to give patients access to experimental therapies.

The bill, which is a priority of Vice President Mike Pence, had been changed from a version that passed the Senate to address concerns raised by FDA Commissioner Dr. Scott Gottlieb. Under the changes, pharmaceutical companies would be required to report any drugs given to patients to the HHS Secretary.

Before the vote, AJMC® spoke with Marjorie Speers, executive director of the W-C-G Foundation, which works to get patients access to experimental drugs through FDA’s expanded access and compassionate use programs. Speers said the House wants to make the drugs readily available, but with controls to ensure patient safety.

“I think they really heard that message.”

AJMC® Talks With Rep. Collins at NCODA

AJMC® was on hand last week for the spring forum of the National Community Oncology Dispensing Association, or NCODA, held in Dallas, Texas. Keynote speaker Congressman Doug Collins of Georgia spoke with AJMC® about difference between providing health insurance and true access to healthcare.

For more coverage from NCODA, visit ajmc.com.

Pembrolizumab Granted Priority Review

Pembrolizumab may be used to treat advanced cervical cancer, now that FDA has accepted Merck’s application for priority review for this indication. This is the first filing for acceptance for an anti-PD-1 therapy in cervical cancer, and the 14th regulatory submission for pembrolizumab, which is sold as Keytruda.

Findings for this indication were presented last month at ASCO’s Genitourinary Cancers Symposium, and showed greater overall survival benefit with recurrent urothelial cancer after being treated with pembrolizumab, compared with chemotherapy.

For more, visit ajmc.com.

AJMC Covers Association of Community Cancer Center Meeting

Finally, business, quality, technology, and policy were all on the agenda this week at the 44th annual meeting of the Association of Community Cancer Centers, which gathered in Washington, DC. AJMC® was on hand for coverage of how cancer clinics are adapting to alternative payment models and the growing role of data and technology in their practices.

For full coverage, visit ajmc.com.

For all of us at the Managed Markets News Network, I’m Kelly Davio.

Thanks for joining us.

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