Formulary Focus: Cosentyx Navigating Tightly Managed Psoriasis Market
Payers’ prior authorization and step therapy requirements may delay broad access to Novartis’ Cosentyx until after competition arrives in 2016 from Lilly’s IL-17 inhibitor and possibly from a biosimilar to Humira.
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FDA approved Johnson & Johnson's IL-23 blocker guselkumab July 13; the drug will be priced at an annual wholesale acquisition cost of $58,100, roughly in line with the currently marketed IL-17 blocker Cosentyx.
There was lots of criticism of pharmacy benefit managers (and a fair amount of pharmaceutical manufacturers) at the oversight hearing. However, Democrats may be more cautious about preserving the benefits PBMs provide versus the downsides in developing reforms.
New GAO recommendations springing from recent Medicare Part D cost and access trends related to rebates may not be relevant going forward because the IRA price negotiation program and benefit redesign will significantly change the landscape, HHS says.