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

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

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


 

 

 

 


 

 






1.



2018 Magellan Rx Management Medical Pharmacy Trend ReportTM,
©2019.





2.




van de Vooren, K., Curto, A. & Garattini, L. Appl Health Econ
Health Policy (2015) 13: 125. https://doi.org/10.1007/s40258-015-0154-9










 

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

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