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Successfully Managing Rising Rx Costs Starts with Accurate Trends

In today’s market if you’re seeing prescription drug trend estimates in the single digits, you should know: those numbers don’t reflect reality. Some trend calculations may focus solely on manufacturer drug price inflation and therefore dramatically understate actual or true prescription benefit trends. To accurately project trends, additional critical factors must be considered:

  • Utilization Patterns – Prescription volume increases yearly as population age and chronic conditions become more prevalent and members simultaneously shift to newer, costlier alternatives. Medical advancements allow for earlier diagnosis which drives longer treatment duration and higher utilization.
  • Specialty and Non-Specialty Pipeline Impact – New to market drugs typically launch at premium price points as compared to existing products. These treatments often expand the treatable population while commanding unprecedented costs.

The Risk of Underestimating

When these factors are properly weighted, we consistently see trends in the mid to higher teens. When plans understate drug trends, they create severe budget shortfalls. This forces employers to make radical mid-year plan design adjustments or significantly increase contributions or benefit reductions the following year, all while making it increasingly difficult to secure stop-loss coverage in the following year without significant rate increases. 

Looking Ahead

While we can’t control drug prices, we can control how benefits are managed. That’s where Benecard Services is different. Instead of just chasing rebates and managing unit costs, we have aligned financial interests with our clients that focus on getting members the right medications while keeping costs in check. No conflicts of interest ― just patient-centered care that works.

With more specialty and GLP-1 drugs in the pipeline, these trends will only intensify. Contact us today at (800) 734-9528 or talktous@benecard.com to discuss how Benecard is helping employers tackle rising drug trends.

New Jersey state capitol building in Trenton

SHBP-Local Government’s Financial Crisis

The NJ State Department of Treasury released a report on May 20th confirming that the State Health Benefits Program for Local Government (SHBP-LG) has become financially unsustainable and needs immediate intervention to survive. The report also states that the School Employee Health Benefits Plan (SEHBP) is on the same trajectory and likely to follow the SHBP-LG’s deterioration.

The Immediate Financial Impact

A potential 26.5% increase could be applied as a combination of a mid-year rate increase in 2025 and/or factored into future renewals. This potential 26.5% increase is a culmination of the 7% premium rate increase required to repay the $120 million dollars still owed on a $258 million dollar loan and based on the SHBP-LG exhausting its claim stabilization reserves (CSR) which calls for an additional 19.5% increase.

This increase would be in addition to normal medical and prescription trends. The State’s consulting firm, Aon, projects prescription trends of 18% to 23% for 2026, with medical trends estimated at 8% to 10% based on current SHBP-LG data.  

What This Means for Plan Sponsors in the SHBP-LG

According to the Department of Treasury, immediate action is necessary for the SHBP-LG to survive. These actions require significant rate increases, forced plan design changes, and/or legislative actions. Plan sponsors should begin evaluating alternatives now to avoid compounding rate increases in 2025 and 2026 as well as potential plan design changes.  

Plan sponsors and their brokers should explore private carriers who can offer full risk protection and/or who can offer access to trusts or group purchasing organizations, which provide for greater stability by spreading the risk through such arrangements. While such quotes will likely show double-digit increases, private carriers do not carry the same financial burden as the SHBP does (i.e., debt burden and CSR requirement), which represents a considerable financial reduction for groups who transition sooner rather than later.

NEXT STEPS

Plan sponsors in the SHBP should obtain their most recent claim experience and census as soon as possible which will allow private carriers to provide the most accurate quotes.   If you are currently contracted with a broker, have them contact Benecard’s Vice President of Sales, Richard Van Noord, at (609) 651-5412 or Richard.VanNoord@benecard.com. If you do not have a broker, you can contact Richard directly to explore available solutions.

ZIIHERA®

FDA Grants Accelerated Approval to Ziihera for the Treatment of HER2-Positive Biliary Tract Cancer

Jazz Pharmaceuticals plc has announced the U.S. Food and Drug Administration (FDA) accelerated approval of Ziihera® (zanidatamab-hrii) 50mg/mL for injection for intravenous use for the treatment of adults with previously treated, unresectable or metastatic HER2-positive (IHC 3+) biliary tract cancer (BTC), as detected by an FDA-approved test. Ziihera was approved under accelerated approval based on a 52% objective response rate (ORR) and a median duration of response (DOR) of 14.9 months as determined by independent central review (ICR).

  • Continued approval for this indication may be contingent upon verification and description of
    clinical benefit in a confirmatory trial.
  • Biliary Tract Cancer, including gallbladder cancer and intrahepatic and extrahepatic
    cholangiocarcinoma, account for <1% of all adult cancers globally and are often associated with a
    poor prognosis.

Source: Jazz Pharmaceuticals plc

GENERIC DRUG APPROVALS

July 2024

  • Indium In-111 Pentetreotide Injection Kit 3 mCi/mL
    Approved: July 1, 2024 – Sun Pharmaceutical Industries, Inc.
    Used for: Diagnosis and Investigation
    Generic for: Octreoscan
  • Bupivacaine Liposome Injectable Suspension 133mg/10mL (13.3mg/mL) and 266mg/20mL
    (13.3mg/mL)
    Approved: July 1, 2024 – Jiangsu Hengrui Pharmaceuticals Co., Ltd.
    Used for: Analgesia
    Generic for: Exparel

June 2024

  • Palbociclib Tablets 75mg, 100mg and 125mg
    Approved: June 5, 2024 – Synthon Pharmaceuticals, Inc.
    Treatment for: Breast Cancer
    Generic for: Ibrance Tablets
  • Avanafil Tablets 50mg, 100mg and 200mg
    Approved: June 14, 2024 – Hetero Labs Limited
    Treatment for: Erectile Dysfunction
    Generic for: Stendra
  • Phentermine Hydrochloride and Topiramate Extended-Release Capsules 3.75mg (base)/23mg,
    7.5mg (base)/46mg, 11.25mg (base)/69mg and 15mg (base)/92mg
    Approved: June 25, 2024 – Actavis Laboratories FL, Inc.
    Treatment for: Obesity
    Generic for: Qsymia

KISUNLA™

FDA Approves Kisunla for the Treatment of Early Symptomatic Alzheimer’s Disease

The U.S. Food and Drug Administration (FDA) has approved Kisunla™ (donanemab-azbt, 350mg/20mL injection for IV infusion) as treatment of early symptomatic Alzheimer’s disease (AD) which includes people with mild cognitive impairment (MCI) as well as people with the mild dementia stage of AD, with confirmed amyloid pathology.

  • Once-monthly Kisunla IV infusion is the first and only amyloid plaque-targeting therapy with evidence to support stopping therapy when amyloid plaques are removed, which can result in lower treatment costs and fewer infusions.
  • Among the overall population of Phase 3 study participants, Kisunla reduced amyloid plaques on average by 61% at 6 months, 80% at 12 months, and 84% at 18 months compared to the start of the study.
  • The FDA’s dosing instructions state that prescribers can consider stopping the dosing of Kisunla based on removal of amyloid plaques to minimal levels as observed on amyloid PET imaging.

Read more…

FDA Gives Nod to RSV Vaccine for People in Their 50s

Medically reviewed by Drugs.com.
By Ernie Mundell HealthDay Reporter

The U.S. Food and Drug Administration on Friday has for the first time approved the use of a respiratory syncytial virus (RSV) vaccine for people in their 50s who are at increased risk for the illness.

  • Drugmaker GSK’s Arexvy vaccine, as well as vaccines from Pfizer and Moderna, are already
    approved for use in adults 60 and older, since age brings higher risk from RSV disease.
  • Arexvy is the first to get the nod for people ages 50 to 59 with certain health risk factors.

Read more…

FDA Approves mRESVIA for Prevention of Lower Respiratory Tract Disease Causedby RSV

The FDA has approved mRESVIA (mRNA-1345), an mRNA respiratory syncytial virus (RSV) vaccine, to protect adults aged 60 years and older from lower respiratory tract disease caused by RSV infection.

  • The approval was granted under a breakthrough therapy designation and marks the second
    approved mRNA product from Moderna. The vaccine uses the same lipid nanoparticles (LNPs) as
    the Moderna COVID-19 vaccines.
  • Moderna expects to have mRESVIA available for eligible populations in the U.S. by the 2024/2025
    respiratory virus season.
    Source: Moderna, Inc.

Read more…

Daybue™

FDA Approves Daybue (trofinetide) for the Treatment of Rett Syndrome

Acadia Pharmaceuticals Inc. announced that the U.S. Food and Drug Administration (FDA) has approved Daybue (trofinetide) for the treatment of Rett syndrome in adult and pediatric patients two years of age and older. Daybue is the first and only drug approved for the treatment of Rett syndrome.

Rett syndrome is a complex, rare, neurodevelopmental disorder typically caused by a genetic mutation on the MECP2 gene. It is characterized by a period of normal development until six to 18 months of age, followed by significant developmental regression with loss of acquired communication skills and purposeful hand use. Symptoms of Rett syndrome may also include development of hand stereotypies, such as hand wringing and clapping, and gait abnormalities. Rett syndrome is believed to affect 6,000 to 9,000 patients in the U.S.,with a diagnosed population of approximately 4,500 U.S. patients. Daybue is not recommended for patients with moderate or severe renal impairment.

Daybue™ is expected to be available in the U.S. by the end of April, 2023.

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Zavzpret

Pfizer Inc. has announced the U.S. Food and Drug Administration (FDA) has approved Zavzpret (zavegepant), the first and only calcitonin gene-related peptide (CGRP) receptor antagonist nasal spray for the acute treatment of migraine with or without aura in adults. There are several other CGRP antagonists currently on the market — some for acute treatment of migraine, others for migraine prevention, and some can be used for both. (i.e. injectables: ajovy, aimovig, emgality, vyepti oral: qulipta, ubrelvy, and nurtec).

In its pivotal Phase 3 study, Zavzpret was statistically superior to placebo on the co-primary endpoints of pain freedom and freedom from most bothersome symptom at two hours post-dose. The pivotal study also demonstrated pain relief as early as 15 minutes in a prespecified secondary endpoint versus placebo.

The FDA approval is based on two pivotal randomized, double-blind, placebo-controlled studies that established the efficacy, tolerability and safety profiles of Zavzpret for the acute treatment of migraine. In these studies, Zavzpret was statistically superior to placebo on the co-primary endpoints of pain freedom (defined as a reduction of moderate or severe headache pain to no headache pain) and freedom from most bothersome symptom at two hours post-dose (defined as the absence of the selfidentified most bothersome symptom).

Zavzpret is contraindicated in patients with a history of hypersensitivity to zavegepant or to any of its components. Hypersensitivity reactions, including facial swelling and urticaria, have occurred with Zavzpret in clinical studies.

Zavzpret is anticipated to be available in pharmacies in July 2023.

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Researchers announce highly accurate blood test for Alzheimer’s Disease

A team of researchers from Rowan-Virtua School of Osteopathic Medicine (RowanVirtua SOM) and Durin Technologies, Inc., have announced the results of a newly-designed blood test that can detect the presence of Alzheimer’s disease-related pathology up to 10 years before symptoms arise with a nearly 97 percent accuracy rate. Their findings appear online ahead of press in the Journal of Alzheimer’s Disease.

The study involved 328 blood samples with the goal of determining if a test that monitors a small number of a patient’s autoantibodies can detect Alzheimer’s disease (AD)-related pathology at presymptomatic, prodromal (i.e., mild cognitive impairment), and mild-moderate stages of the disease.

The research team showed that their test, using just eight autoantibody biomarkers, could accurately identify the presence of Alzheimer’s disease pathology across the disease’s progression, including among those originally determined to have no trace of the disease.

For a number of reasons, the test has significant potential to impact effective treatments for Alzheimer’s disease. The test is minimally invasive and inexpensive, it can diagnose or predict clinical decline in asymptomatic individuals, and it can monitor a patient’s progress while under treatment, making it ideal for use in clinical trials and in frontline and community primary care settings, including those in rural and economically disadvantaged regions.

The researchers noted that the use of autoantibodies as blood-based biomarkers is particularly exciting because it enables development of a platform technology for early detection of multiple diseases.

Read more…