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    How RA, Cancer, Hep C Drug Costs Will Change Over Next Five Years

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    Cancer

    Jessica Turgon, principal at ECG, a management consulting firm, predicts that prices for cancer drugs will rise in the next five years as the FDA approves more drugs for oncology conditions. “Manufacturers are trying to recoup their investment in developing high-cost drugs, but they are feeling pressure from the industry to keep increases at 10% or lower,” she says. “There are no price controls.”

    Strahl agrees. “There are only about two to three drugs per cancer indication so there’s not much activity by manufacturers to discount them,” she says. “It’s up to PBMs and insurers to pressure them; manufacturers are primarily in the driver’s seat.”

    Stettin expects a robust oncology pipeline but going forward, he also predicts less competition due to specification. On the other hand, he anticipates that generic versions of Gleevec could impact drug pricing.

    Mona Chitre, PharmD, chief pharmacy officer and vice president, clinical operations and health innovation, Excellus BlueCross BlueShield, attributes the rising cost of oncology drugs to new combinations, such as Opdivo (nivolumab) that has been used as a single agent to treat metastatic melanoma and is now prescribed in combination with Yervoy (ipilimumab). The price has jumped from a $150,000 single agent to $250,000 for both.

    David Lassen, PharmD, chief clinical officer, Prime Therapeutics, a PBM, attributes the higher cost of drugs to their marked improvement in efficacy, advancement toward a cure, lack of competition, and new drugs targeting additional indications.

    Hep C

    Stettin says Hep C drug utilization has tanked and will be flat by 2019 to 2020 even though drugs for the condition are expensive. “Hepatitis C is extremely well managed, and we have identified those who need the drugs and ensured adherence,” he says.

    Strahl, of HealthPartners also expects utilization to decrease but right now she says there is a slight increase with new drugs that fight resistance experienced by some patients on other drugs. Among them are Mavyret (glecaprevir/pibrentasvir).

    HealthPartners has created a Pharmacy Navigator program for Hep C that supports members on high-cost drugs through personalized outreach to increase adherence and contain costs.

    Mari Edlin, a frequent contributor to Managed Healthcare Executive, is based in Sonoma, California.

     

    Mari Edlin
    Mari Edlin is a frequent contributor to Managed Healthcare Executive. She is based in Sonoma, California.

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