Managing the Unmanageable
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- Eunice Cameron
- 5 years ago
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1 Managing the Unmanageable Controlling Costs in an Explosive Rx Environment Presented by: Dick Bullard, RPh, SVP Pharmacy Darryl Martin, VP of Sales
2 A Unique Vision of Care Magellan Health is a healthcare management company that focuses on the fast-growing, complex, and high-cost areas of healthcare with an emphasis on special population management. 44 million Our three businesses address complete person care for brighter futures and a better quality of life. 45 million 22 million 2
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5 FDA NME Drug Approvals 30 Traditional 25 Specialty
6 Pipeline Report Specialty Medications Notables Pipeline Rx Anticipated Approval What is the drug being developed for? Estimated Cost alirocumab (Praluent Sanofi /Regeneron) 2015 High cholesterol; SQ injection $12K/year AZD 9291 (AstraZeneca) 2016 Cancer; oral $100K/year evolocumab (Repatha Amgen) 2015 High cholesterol; SQ injection $12K/year lenvatinib (Lenvima Eisai) 2015 Thyroid cancer; oral $12K/month palbociclib (Ibrance Pfizer) 2015 Breast cancer; oral $5K $10K/month panobinostat (Farydak Novartis) 2015 Multiple Myeloma; oral $9K/month secukinumab (Cosentyx Novartis) 2015 Chronic plaque type psoriasis; SQ injection $4,500/month 6
7 Patent Expiration Report Notables Year ( ) Month/Day Brand Generic Manufacturer Common Use Impact* Medication Type 2015 April 20 Abilify aripiprazole Bristol Myers Squibb Mental/Neuro Disorders M Traditional 2015 June 22 EpiPen Auto Injector epinephrine Mylan Misc Conditions L M Traditional 2015 August 31 Androgel 1% testosterone gel AbbVie Hormonal Supplementation L M Traditional 2015 November 20 Tracleer bosentan Actelion Circulatory Disorders L Specialty Copaxone 20mg/mL glatiramer acetate Teva Mental/Neuro Disorders L Specialty 2016 October 25 Benicar olmesartan Forest High Blood Pressure/Heart Disease L M Traditional 2016 October 25 Benicar HCT olmesartan / HCTZ Forest High Blood Pressure/Heart Disease L M Traditional 2016 December 12 Zetia ezitimibe Schering Plough High Blood Cholesterol L Traditional 2016 December 13 Lupron Depot leuprolide acetate AbbVie Cancer L M Specialty H 2016 Advair Diskus salmeterol / fluticasone GlaxoSmithKline Asthma H Traditional *Very Low (VL) <50 pts; Low (L) pts; Medium (M) pts; High (H) pts; Very High (VH) 1,000 pts 7
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9 Best-in-Class Specialty Model 9
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11 Optimal Patient Engagement through Technology Customized video with information about the specific medication, dosage and how to administer Available right on your prescription to scan anytime you want more information on your medication Available in English and Spanish, videos provide comprehensive information on top prescribed medications, including proper usage, expected benefits and potential side effects 11
12 Smart Hepatitis C Management Utilization Management Patient Engagement Site of Care Program Integrity 12
13 13 Smart Hepatitis C Management
14 What to do? Options for Managing: Exclude via benefit design Pharmacy Medical Cover with no stipulation costly and high risk Cover with comprehensive Clinical Management Policies/Magellan Rx
15 Next Wave Horizon Cholesterol Management Insulin Category New Technology *Download the Trend Report Now 15
16 Pipeline Report Specialty Medications Pipeline Rx Anticipated Approval What is the drug being developed for? Estimated Cost alirocumab (Praluent Sanofi /Regeneron) 2015 High cholesterol; SQ injection $12K/year asfotase alfa (Alexion) 2015 Hypophosphatasia; SQ injection $200K 300K/year AZD 9291 (AstraZeneca) 2016 Cancer; oral $100K/year brodalumab (Amgen / AstraZeneca) 2015 Psoriasis; SQ injection $4,500/month daclatasvir (Bristol Myers Squibb) 2015 Hepatitis C; oral $80K $100K/year daclizumab (Zinbryta Biogen Idec/AbbVie) 2015 Multiple Sclerosis; SQ injection $40K/year daratumumab (Janssen) 2015 Cancer; IV $150K/year drisapersen (BioMarin Pharmaceutical) 2015 Duchenne Muscular Dystrophy; SQ injection $300K/year dupilumab (Regeneron / Sanofi) 2015 Eosinophilic asthma/atopic dermatitis; SQ injection $30K/year evolocumab (Repatha Amgen) 2015 High cholesterol; SQ injection $12K/year grazoprevir / elbasvir (MK 5172 /MK 8742 Merck) 2016 Hepatitis C; oral $80K $100K/ treatment course lenvatinib (Lenvima Eisai) 2015 Thyroid cancer; oral $12K/month lumacaftor (Vertex) 2015 Cystic Fibrosis; oral $300K/year mepolizumab (Bosatria GlaxoSmithKline) 2015 Eosinophilic asthma; SQ injection $10K/year migalastat (Amigal Amicus) 2015 Fabry disease; oral $100K $300K/year palbociclib (Ibrance Pfizer 2015 Breast cancer; oral $5K $10K/month panobinostat (Farydak Novartis) 2015 Multiple Myeloma; oral $9K/month rociletinib (Clovis Oncology) 2016 Lung cancer; oral $100K/year sebelipase alfa (Kanuma Synageva) 2015 Woolman disease/lysosomal acid lipase deficiency; IV $400K/year secukinumab (Cosentyx Novartis) 2015 Chronic plaque type psoriasis; SQ injection $4,500/month 16
17 Patent Expiration Report Year ( ) Month/Day Brand Generic Manufacturer Common Use Impact Medication Type 2015 Jan. 09 Zyvox inj linezolid Pfizer Infections VL Traditional 2015 Jan. 12 Clobex 0.05% Spray 2015 Feb. 01 Cosopt PF 2015 Feb. 24 Tarka clobetasol propionate spray dorzolamide / timolol trandolapril / verapamil Galderma Skin Disorders VL Traditional Akorn Misc Conditions VL Traditional AbbVie High Blood Pressure/Heart Disease VL Traditional 2015 Mar. 02 Welchol colesevelam Daiichi Sankyo High Blood Cholesterol VL Traditional 2015 Mar. 02 Welchol Powder colesevelam Daiichi Sankyo High Blood Cholesterol VL Traditional 2015 Apr. 01 Generess FE norethindrone / EE / Fe Actavis Contraceptives VL Traditional 2015 Apr. 18 Emend capsules aprepitant Merck Nausea/Vomiting VL Traditional 2015 Apr. 20 Abilify aripiprazole 2015 Apr. 20 Abilify Discmelt aripiprazole Bristol Myers Squibb Bristol Myers Squibb Mental/Neuro Disorders M Traditional Mental/Neuro Disorders VL Traditional 2015 Apr. 26 Oxytrol oxybutynin transdermal Actavis Urinary Disorders VL Traditional 2015 May. 18 Zyvox tablets linezolid Pfizer Infections VL Traditional Very Low (VL) <50 pts; Low (L) pts; Medium (M) pts; High (H) pts; Very High (VH) 1,000 pts 17
18 Patent Expiration Report (cont.) Year ( ) Month/Day Brand Generic Manufacturer Common Use Impact Medication Type 2015 Jun. 02 Integrilin eptifibatide Merck Blood Modifying VL Traditional 2015 Jun. 06 Cipro HC Otic ciprofloxacin / hydrocortisone Otic 2015 Jun. 15 Angiomax bivalirudin Alcon Eye Drugs VL Traditional Medicines Company Anticoagulant VL Traditional 2015 Jun. 15 Factive gemifloxacin Cornerstone Infections VL Traditional 2015 Jun. 22 EpiPen Auto Injector epinephrine Mylan Misc Conditions L M Traditional 2015 Jul. 01 Aggrenox aspirin / Boehringer dipyridamole Ingelheim Blood Modifying VL Traditional 2015 Jul. 07 Trelstar triptorelin pamoate Watson Cancer Medical 2015 Jul. 09 Targretin Capsules bexarotene Eisai Cancer VL Specialty 2015 Jul. 11 Namenda memantine Actavis Mental/Neuro Disorders VL Traditional 2015 Jul. 31 Finacea azelaic acid topical gel Intendis Skin Disorder L Traditional 2015 Aug. 15 Xenazine tetrabenazine Valeant Mental/Neuro Disorders VL Specialty 2015 Aug. 31 Androgel 1% testosterone gel AbbVie Hormonal Supplementation L M Traditional Very Low (VL) <50 pts; Low (L) pts; Medium (M) pts; High (H) pts; Very High (VH) 1,000 pts 18
19 Patent Expiration Report (cont.) Year ( ) Month/Day Brand Generic Manufacturer Common Use Impact Medication Type 2015 Sep. 01 Daytrana methylphenidate Shire Attention Disorders VL Traditional 2015 Sep. 03 DepoCyt cytarabine, depot Pacira Pharms Cancer VL Traditional 2015 Oct. 01 Fenoglide fenofibrate Santarus High Blood Cholesterol VL Traditional 2015 Oct. 11 Namenda Oral Solution memantine Actavis Mental/Neuro Disorders VL Traditional 2015 Oct. 13 Aloxi palonosetron Aloxi Nausea/Vomiting VL Traditional 2015 Nov. 07 Axert almotriptan Ortho McNeil Migraine Headaches VL Traditional 2015 Nov. 07 Frova frovatriptan Endo Migraine Headaches VL Traditional 2015 Nov. 15 Asacol HD mesalamine Actavis GI Disorders VL Traditional Q 2015 Avodart dutasteride GlaxoSmithKline Urinary Disorders VL Traditional Q 2015 Jalyn dutasteride / tamsulosin GlaxoSmithKline Urinary Disorders VL Traditional 2015 Nov. 20 Tracleer bosentan Actelion Circulatory Disorders L Specialty 2015 Dec. 05 Mirena levonorgestrel Bayer Contraceptives Medical Very Low (VL) <50 pts; Low (L) pts; Medium (M) pts; High (H) pts; Very High (VH) 1,000 pts 19
20 Patent Expiration Report (cont.) Year ( ) Month/Day Brand Generic Manufacturer Common Use Impact Medication Type 2015 Dec. 06 Patanol olopatadine Alcon Eye Drugs L Traditional 2015 Dec. 07 Fuzeon enfuvirtide Roche HIV VL Specialty 2015 Dec. 19 Femring estradiol acetate Galen Vaginal Disorders VL Traditional Copaxone 20mg/mL glatiramer acetate Teva Mental/Neuro Disorders L Specialty ethinyl estradiol / 2015 Dec. 31 Ortho Tri Cyclen Lo Janssen Contraceptives L Traditional norgestimate H 2015 Renagel sevelamer Genzyme GI Disorders VL Traditional 2016 Feb. 01 Gleevec imatinib Novartis Cancer VL Specialty 2016 Feb. 01 Glumetza metformin e.r. Santarus Diabetes VL Traditional 2016 Mar. 11 Visudyne verteporfin inj. QLT Eye Drugs Medical 2016 Mar. 15 Enablex darifenacin, e.r. Novartis Urinary Disorders VL Traditional 2016 Mar. 23 Muse alprostadil urethral suppository Vivus Circulatory Disorder VL Traditional 2016 Mar. 26 AcipHex Sprinkles rabeprazole Eisai Ulcer Disease VL Traditional Very Low (VL) <50 pts; Low (L) pts; Medium (M) pts; High (H) pts; Very High (VH) 1,000 pts 20
21 Patent Expiration Report (cont) Year ( ) Month/Day Brand Generic Manufacturer Common Use Impact 2016 Mar. 28 Epzicom abacavir / lamivudine Medication Type ViiV Healthcare HIV VL Specialty 2016 May. 02 Crestor rosuvastatin AstraZeneca High Blood Cholesterol M Traditional 2016 Jun. 15 Cubicin daptomycin Cubist Infections VL Traditional 2016 June 2016 Nuvigil armodafinil Cephalon Attention Disorders/Wt Loss VL Traditional 2016 July 2016 Ziana clindamycin/tretin oin gel Medicis Skin Disorders VL Traditional 2016 Aug. 02 Tamiflu oseltamivir Roche Viral Infections H Traditional 2016 Sep. 11 Aczone dapsone gel Allergan Skin Disorders L Traditional 2016 Sep. 15 Zirgan ganciclovir ophthalmic gel Bausch & Lomb Eye Drugs VL Traditional 2016 Oct. 12 Ambisome amphotericin B Gilead Fungal Infections VL Traditional 2016 Oct. 25 Azor amlodipine / olmesartan Daiichi Sankyo High Blood Pressure/Heart Disease VL Traditional 2016 Oct. 25 Benicar olmesartan Forest High Blood Pressure/Heart Disease L M Traditional 2016 Oct. 25 Benicar HCT olmesartan / HCTZ Forest High Blood Pressure/Heart Disease L M Traditional Very Low (VL) <50 pts; Low (L) pts; Medium (M) pts; High (H) pts; Very High (VH) 1,000 pts 21
22 Patent Expiration Report (cont.) Year ( ) Month/Day Brand Generic Manufacturer Common Use Impact Medication Type 2016 Oct. 25 Tribenzor 2016 Nov. 01 Seroquel XR capsules amlodipine / olmesartan / HCTZ Daiichi Sankyo High Blood Pressure/Heart Disease quetiapine, extended release VL Traditional AstraZeneca Mental/Neuro Disorders VL Traditional 2016 Dec. 12 Zetia ezitimibe Schering Plough High Blood Cholesterol L Traditional 2016 Dec. 13 Lupron Depot leuprolide acetate AbbVie Cancer L M Specialty 2016 Dec. 19 ProAir HFA albuterol MDI Teva Asthma H Traditional 2016 Dec. 26 Kaletra Tablets lopinavir AbbVie HIV VL L Traditional H 2016 Advair Diskus salmeterol / fluticasone GlaxoSmithKline Asthma H Traditional Q 2016 Azilect rasagiline Teva Parkinsons Disease VL Traditional Very Low (VL) <50 pts; Low (L) pts; Medium (M) pts; High (H) pts; Very High (VH) 1,000 pts 22
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34 Contact Information Darryl Martin Vice President, Sales (480) Richard Bullard, RPh Senior Vice President, Pharmacy (480)
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