SCOTTSDALE, Ariz.--(BUSINESS WIRE)--Magellan Rx Management, the pharmacy benefit management (PBM) division of
Health, Inc. (NASDAQ: MGLN), released new data today showcasing
results from its medical pharmacy program focused on biosimilar
management. The results revealed that health plan organizations saw a
significant shift in utilization from high-cost drugs to lower-cost
biosimilar formulations after implementation of a medical benefit drug
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management solution, yielding substantial drug cost savings while
maintaining a high level of clinical quality.
Producing Real Savings with a Forward-Thinking Approach
The program leverages a comprehensive utilization management (UM)
solution to shift utilization to the lower-cost biosimilar versions of
infliximab, which is used to treat autoimmune conditions such as
rheumatoid arthritis and inflammatory bowel disease. In support of this
initiative, a team of highly-trained pharmacists developed a robust
clinical policy, working with physician offices and hospitals to ensure
appropriate utilization for each patient’s unique situation. Though not
considered directly interchangeable with their innovator brand
counterparts, biosimilars are regarded as providing the same levels of
clinical efficacy and safety, while offering the added benefit of
potential cost-savings to payers and patients alike.
“These are difficult-to-manage therapies,” said Steve Cutts, senior vice
president and general manager, specialty. “But with over 16 years of
targeted, total specialty drug management expertise, Magellan Rx—and our
health plan customers—are in a prime position to embrace biosimilar
availability of these high-cost drugs and produce real savings for all
involved, not only through our clinically-sound utilization management
program but also by negotiating enhanced discounts for the biosimilar
versions.”
Health plan customers implementing a comprehensive management approach
that transitions all patients to a biosimilar agent have reported a
shift in market share of up to 86 percent.
Even when utilizing a softer approach that mandates only new patients
use the biosimilar version, health plans have experienced an uptake in
biosimilar utilization as high as 75 percent.
According to the latest edition of the Magellan
Rx Management Medical Pharmacy Trend ReportTM, Remicade,
the brand name for infliximab, is the highest-spend drug on the medical
benefit.1 Although biosimilar competition for infliximab has
existed since 2016 in the United States, health plans have continued to
see an increase in infliximab spend, including a 14 percent increase in
Remicade per-member-per-month (PMPM) for commercial health plans from
2016 to 2017.1 It’s reported that payers spend $43,000 per
patient annually1 on the reference brand, yet the ingredient
cost of biosimilars can be up to 35 percent less.2 Furthermore,
medical pharmacy management strategies coupled with benefit design
changes can have meaningful impact on lowering patient out-of-pocket
costs.
“Leveraging our expertise in this field, we help our customers take
advantage of leading-edge, thoughtful formulary management and clinical
programs that can drive true drug cost savings,” said Cutts. “We look
forward to building upon our early successes here, and continuing to
roll up our sleeves and solve complex specialty pharmacy challenges.”
For more on the latest in medical pharmacy trends and biosimilar
management strategies, download the ninth edition of the Magellan
Rx Management Medical Pharmacy Trend Report.
1. | 2018 Magellan Rx Management Medical Pharmacy Trend ReportTM, ©2019. | ||||||
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About Magellan Rx Management: Magellan
Rx Management, a division of Magellan
Health, Inc., is a full-service, next-generation pharmacy benefit
manager (PBM) that helps our customers and members solve complex
pharmacy challenges by connecting them to the people, technology, and
information they need to make smarter healthcare decisions. As experts
in managing specialty spend both on the prescription and medical
benefit, we are energized by discovering new and better ways to deliver
solutions in today’s complex and rapidly-evolving healthcare
environment, leading people to live healthier, more vibrant lives.
About Magellan Health: Magellan
Health, Inc., a Fortune
500 company, is a leader in managing the fastest growing, most
complex areas of health, including special populations, complete
pharmacy benefits and other specialty areas of healthcare. Magellan
supports innovative ways of accessing better health through technology,
while remaining focused on the critical personal relationships that are
necessary to achieve a healthy, vibrant life. Magellan's customers
include health plans and other managed care organizations, employers,
labor unions, various military and governmental agencies and third-party
administrators. For more information, visit MagellanHealth.com.
(MGLN-GEN)
Contacts
Media Contact: Lilly Ackley, ackleyl@magellanhealth.com,
(860) 507-1923
Investor Contact: Joe Bogdan, jbogdan@magellanhealth.com,
(860) 507-1910