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☆ Analysts predicted new obesity medicines would be blockbusters. Now they’re raising their forecasts
▼ + stars: | 2023-09-16 | by ( Christina Cheddar Berk | ) www.cnbc.com time to read: +9 min

Fernandez sees a total addressable market of $140 billion to support patients with obesity. He expects there is a potential for GLP-1 drugs to become as common and widely used, much like statins are used to lower cholesterol. Morgan Stanley's Flynn estimates a 30% share of the diabetes market would generate $109 billion on a worldwide basis for GLP-1 drugs. Layer in a 15% to 30% share of the obesity market and that equates to worldwide sales of $97.4 billion to $194.8 billion. Guggenheim's estimates also assume that oral GLP-1 drugs that are currently in development are able to come to market a few years from now.

Persons: Seamus Fernandez, Fernandez, Lilly, Eli Lilly, Morgan Stanley, Terence Flynn, Eli Lilly's Mounjaro, Insulet, Canaccord, William Plovanic, Plovanic, It's, Morgan Stanley's Flynn, Flynn, Novo, Michael Bloom Organizations: Wall, Novo, American Heart Association, Food and Drug Administration, Novo Nordisk, Iqvia, Disease Control Locations: GLP

CVS Health logo is seen displayed in this illustration taken, May 3, 2022. The regional health insurance provider will still retain CVS Caremark for managing specialty drugs, which are costly medications used to treat complex conditions like cancer and rheumatoid arthritis. Other analysts highlighted difficulties in shifting to a different model than the one offered by companies like CVS - which provide other services including home drug delivery and reimburse pharmacies for patients' prescriptions. Amazon Pharmacy will provide at-home delivery of prescription drugs as well as upfront pricing, while Mark Cuban Cost Plus Drug Company will provide access to generic drugs, Blue Shield said. Blue Shield of California's other partners include privately held Abarca for processing claims related to prescription drugs, while smaller PBM Prime Therapeutics will work to negotiate savings with drugmakers.

Persons: Dado Ruvic, Cigna, UnitedHealth, Mark, Elizabeth Anderson, J.P, Morgan, Lisa Gill, Gill, Blue, Manas Mishra, Mariam Sunny, Bhanvi, Shweta Agarwal, Pooja Desai, Krishna Chandra Eluri, Frances Kerry Organizations: CVS, REUTERS, Amazon, Cigna, UnitedHealth, Evercore ISI, Mark Cuban, Plus, Thomson Locations: Bengaluru

☆ Blue Shield of California drops CVS, taps Amazon and others to lower drug costs
▼ + stars: | 2023-08-17 | by ( ) www.reuters.com time to read: +2 min

CVS Health logo is seen displayed in this illustration taken, May 3, 2022. Blue Shield, whose health plans cover 4.8 million members, said it will now work with five different companies, including Mark Cuban's drug company, to provide "convenient, transparent access to medications while lowering costs." Privately held Abarca will pay prescription drug claims, while Prime Therapeutics will work with Blue Shield to negotiate savings with drugmakers, the company said. Blue Shield will also work with CVS Caremark for specialty pharmacy services. The loss of the Blue Shield pharmacy benefit management contract is another blow to Caremark, which is also set to lose the contract to manage Centene's (CNC.N) $40 billion annual pharmacy needs from next year.

Persons: Dado Ruvic, UnitedHealth, Mark Cuban's, Paul Markovich, Mark, Manas Mishra, Mariam Sunny, Bhanvi, Shweta Agarwal, Pooja Desai Organizations: CVS, REUTERS, Blue, Cigna, UnitedHealth, Pharmacy, Wall Street, Mark Cuban, Plus, Thomson Locations: Blue, Bengaluru

☆ Blue Shield California drops CVS; picks Amazon, others to lower drug price
▼ + stars: | 2023-08-17 | by ( ) www.reuters.com time to read: +1 min

CVS Health logo is seen displayed in this illustration taken, May 3, 2022. Non-profit health plan provider Blue Shield, which has 4.8 million members, said it will work with partners including Amazon.com and Mark Cuban's Cost Plus Drug Company to provide at-home delivery and access to low-cost medications. Privately held Abarca will pay prescription drug claims, while Prime Therapeutics will work with Blue Shield to negotiate savings with drugmakers, the company said. Blue Shield will also work with CVS Caremark for specialty pharmacy services. The loss of Blue Shield marks another blow to Caremark, which is also set to lose the contract to manage Centene's (CNC.N) $40 billion annual pharmacy needs from next year.

Persons: Dado Ruvic, Cuban's, Privately, Manas Mishra, Mariam Sunny, Bhanvi, Shweta Agarwal, Pooja Desai Organizations: CVS, REUTERS, Wall Street Journal, Cigna, UnitedHealth, Company, Thomson Locations: Bengaluru

☆ Exclusive: Most patients using weight-loss drugs like Wegovy stop within a year, data show
▼ + stars: | 2023-07-11 | by ( Chad Terhune | ) www.reuters.com time to read: +4 min

The annual cost of overall care for patients prior to taking Wegovy or a similar drug was $12,371, on average, according to the analysis. The costs for a similar control group of patients not taking the drugs decreased by 4% over the same period. The analysis by Prime Therapeutics, a pharmacy benefits manager (PBM), reviewed pharmacy and medical claims data for 4,255 people with commercial health plans. For the analysis, Prime Therapeutics excluded patients with type 2 diabetes to focus on obesity treatment. In trials with adults, Novo found that 6.8% of patients taking Wegovy discontinued treatment due to gastrointestinal problems and other adverse events.

Persons: Wegovy, Khrysta Baig, Patrick Gleason, Novo, aren't, Gleason, David Lassen, Lassen, Chad Terhune, Michele Gershberg, Bill Berkrot Organizations: Reuters, Vanderbilt University, Novo Nordisk, Prime Therapeutics, Therapeutics, U.S, Blue, Thomson Locations: Danish

☆ Few patients continue weight loss drugs like Wegovy after a year — but health costs soar for all
▼ + stars: | 2023-07-11 | by ( Annika Kim Constantino | ) www.cnbc.com time to read: +4 min

A selection of injector pens for the Wegovy weight loss drug are shown in this photo illustration in Chicago, Illinois, March 31, 2023. And a group of patients in the analysis who didn't take a weight loss drug saw their health-care costs decrease by 4% on average during the same time period. Weight loss drugs are also known as GLP-1 agonists, which mimic a hormone produced in the gut to suppress a person's appetite. Prime Therapeutics' analysis does not indicate why patients stopped taking weight loss drugs. But experts say the medicines may further perpetuate a dangerous diet culture that idealizes weight loss and thinness.

Persons: Joseph Leach, Eli Lilly, Elon Musk Organizations: Novo Nordisk, CNBC, Prime Therapeutics, Food and Drug Administration, Therapeutics, Reuters, Pfizer, National Institutes of Health Locations: Chicago , Illinois, U.S, Danish

☆ Inside your company's struggle over whether to pay for hot, new weight-loss drugs
▼ + stars: | 2023-06-20 | by ( ) www.businessinsider.com time to read: +10 min

Americans are clamoring for new weight-loss drugs, but companies aren't rushing to pay for them. At most, half of US employers help pay for weight-loss drugs for their workers, according to several estimates. "The drug companies, providers, and patient groups are insisting that weight loss will improve health and therefore offset these massive costs. Known as GLP-1 agonists, the drugs — Wegovy and Ozempic from Novo Nordisk and Eli Lilly's Mounjaro — mimic a gut hormone known as glucagon-like peptide 1, helping to suppress people's appetites and slow their digestion. Brent Eberle, the chief pharmacy officer at Navitus, said very few of the employers that worked with his pharmacy-benefit manager paid for weight-loss drugs.

Persons: that's, They're, AJ Loiacono, Li Ran, James Gelfand, Eli Lilly's, Ozempic, drugmakers, Brent Eberle, Navitus, Eberle, it's, Pat Gleason, Gleason, Wegovy, Eli Lilly, Lilly, Florian Gaertner, Loiacono Organizations: Morning, Novo Nordisk, Getty, Workers, Drugmakers, Therapeutics, Blue, Mayo Clinic, and Drug Administration, Capital Locations: Novo, Xinhua

☆ US FTC expands probe into pharmacy benefit managers
▼ + stars: | 2023-05-17 | by ( ) www.reuters.com time to read: +1 min

May 17 (Reuters) - The U.S. Federal Trade Commission said it had sought information from two privately held companies that negotiate drug rebates on behalf of pharmacy benefit managers (PBMs) as part of its probe into how PBMs affect pricing of prescription drugs. The two companies, Zinc Health Services and Ascent Health Services, are group purchasing organizations, that negotiate after-market discounts or rebates with drug manufacturers on behalf of PBMs and hold the contracts that govern those rebates. Zinc Health negotiates rebates for CVS Health Corp (CVS.N) and Ascent Health for Cigna Group's (CI.N) Express Scripts unit and Prime Therapeutics, which is a privately held PBM, the FTC said on Wednesday. PBMs act as middlemen and negotiate rebates and fees with drug manufacturers, create lists of medications that are covered by insurance, and reimburse pharmacies for patients' prescriptions. Reporting by Manas Mishra in Bengaluru Editing by Vinay DwivediOur Standards: The Thomson Reuters Trust Principles.

☆ Drug Middlemen Accused of Price Fixing by Ohio Attorney General
▼ + stars: | 2023-03-27 | by ( Jared S. Hopkins | ) www.wsj.com time to read: 1 min

A price-fixing lawsuit that Ohio filed Monday against several firms that manage billions of dollars in drug benefits ratchets up scrutiny of the companies while shining a spotlight on their new tactic using overseas subsidiaries. The lawsuit filed Monday by the Ohio attorney general in a state court alleges Cigna Corp., Humana Inc. and Prime Therapeutics LLC shared pricing and other information gathered by a Swiss subsidiary to gain leverage during negotiations with drugmakers for rebates.

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