ESI Reachs Deal on Struggling Cholesterol Drug with a List Price Over $8000

Image result for praluent copay cardDrugmakers Regeneron and Sanofi are cutting the price they charge pharmacy benefit manager Express Scripts for their cholesterol medicine, Praluent. In return, Express Scripts will remove almost all restrictions on the medicine, and make it cheaper for patients. In theory, that should mean a sales boost.

“I really hope this works because otherwise it’s a bad message for everyone going forward,” says Steve Miller, Express Scripts’ chief medical officer. Why? Miller says that Praluent was hurt by a high price (list: $14,000 a year), and a lack of proof that it helped patients. But now, Miller says, things have changed.

Tyrone’s Commentary:

1) Reads as if ESI is rubberstamping the PA (prior auth) for a drug with a list price of more than $8,000.
2) Plan sponsors need to understand the manufacturer-side revenue ESI is generating for itself and its affect on your final plan cost!
3) The drug appears to be cost-effective even at the high price tag, but make sure not to be wasteful in your spending
4) Plan sponsors may want to consider implementing their own step therapy and PA processes or excluding the drug all together except for extreme cases   

New data presented in March seems to indicate that Praluent not only prevents heart attacks, but may save lives. And Regeneron and Sanofi opened themselves up to an independent analysis, by the Institute For Clinical and Economic Review, that showed the medicine was cost-effective at a price below $8,000 for high risk patients. Now they’ve cut the price.

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“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels

How many businesses do you know want to cut their revenues in half? That’s why traditional pharmacy benefit managers don’t offer radical transparency and instead opt for hidden cash flow opportunities such as rebate masking. Want to learn more?


Here is what some participants have said about the webinar.

“Thank you Tyrone. Nice job, good information.” David Stoots, AVP
“Thank you! Awesome presentation.” Mallory Nelson, PharmD
 
“Thank you Tyrone for this informative meeting.” David Wachtel, VP

“…Great presentation! I had our two partners on the presentation as well. Very informative.” Nolan Waterfall, Agent/Benefits Specialist

A snapshot of what you will learn during this 30 minute webinar:

  • Hidden cash flows in the PBM Industry such as formulary steering, rebate masking and differential pricing
  • How to calculate cost of pharmacy benefit manager services or CPBMS
  • Specialty pharmacy cost-containment strategies
  • The financial impact of actual acquisition cost (AAC) vs. maximum allowable cost (MAC)
  • Why mail-order and preferred pharmacy networks may not be the great deal you were sold
Sincerely,
TransparentRx
Tyrone D. Squires, MBA  
3960 Howard Hughes Pkwy., Suite 500  
Las Vegas, NV 89169  
866-499-1940 Ext. 201


P.S.  Yes, it’s recorded. I know you’re busy … so register now and we’ll send you the link to the session recording as soon as it’s ready.