employers’ forum of indiana welcome · 9/25/2019 · - us has 4 fda approved biosimilars: a....
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EMPLOYERS’ FORUM OF INDIANA
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EMPLOYERS’ FORUM OF INDIANA
PERSPECTIVE ON HIGH DRUG COSTS
EFI All-Stakeholder Meeting
Indianapolis, IN
Wednesday, September 25, 2019
Gloria Sachdev, PharmD
President and CEO, Employers’ Forum of Indiana
SHADYWhat is the best-selling drug in the world?
Humira- launched in US in 2003; $19,000 in 2012 and $38,000 in 2018 (after rebates)
- TNF blocker for inflammatory conditions, called a biologic
- US has 4 FDA approved biosimilars:
a. Hadlima by Abbvie in 2019, co-market with Merck
b. Hyrimoz by Sandoz in 2018
c. Cyltezo by Boeringer Ingelheim in 2017
d. Amjevita by Amgen in 2016
- Not available in US because of a 20-year US patent protection for Humira which expires in 2023
- BUT BIOSIMILARS AVAILABLE IN EUROPE AS OF 2018
- NHS agency of England negotiated price decrease by 75% & now cost is $4500 annually for high dose
How much money did Abbvie make on Humira in 2018?
$20 billion
SUPER SHADY3. What is the most expensive drug in the world? Zolgensma for $2 million
- Used to treat spinal muscular atrophy (SMA effects 1 in 10,000 live births)
- One-time gene therapy treatment
4. What is the recent DRAMA about this drug?
- FDA approved in May 2019 - BUT in March 2019 Novartis learned that chief
scientists submitted FAKE data to FDA and Novartis didn’t tell the FDA
- They eventually fired their chief scientists in August 2019
- FDA decided to keep this medication on the market for now
Results of Forum Employer Survey Regarding Prescription MedicationConducted by the Employers’ Forum of Indiana in Partnership With the National Alliance of Healthcare Purchasers’ Coalition
sent August 2019
SELECT YOUR COMPANY’S INDUSTRYN=13
46%
8%
31%
8% 8%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Educational
Services
Finance and
Insurance
Manufacturing Professional,
Scientific, and
Technical
Services
Transportation,
Warehousing
and Utilities
INDICATE THE SIZE OF YOUR ACTIVE EMPLOYEE POPULATION N=12
42%
17%
8%
33%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Between 1,001 - 5,000 Between 5,001 -
10,000
Between 10,001 -
20,000
Over 20,000
WHAT IS YOUR AVERAGE DRUG SPEND PER COVERED LIFE (PMPY)?N=12
8%
17%
33%
25%
17%
0%
5%
10%
15%
20%
25%
30%
35%
Less than $100 $101-$500 $501-$1,000 $1,001-$2,000 $2,001-$3,000
WHAT IS YOUR PERSPECTIVE REGARDING YOUR DRUG SPEND?N=13
54%
46%
0%
10%
20%
30%
40%
50%
60%
Too high and not
sustainable
Too high and
sustainable
Reasonable Too low
BESIDES COST, WHAT ARE YOUR KEY CHALLENGES WITH MANAGING YOUR DRUG TREND?N=13
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%PB
Ms
offe
rin
g a
dru
g
form
ula
ry b
ase
d o
n v
alu
e
of th
e d
rug
De
cid
ing
wh
ich
dru
g t
o
exc
lud
e f
rom
fo
rmu
lary
Issu
e w
ith
PB
M c
on
tra
cts
Kn
ow
ing
wh
at
dru
g c
ost
s
go
th
rou
gh
me
dic
al
Co
st o
f sp
ec
ialty
dru
gs
Ove
r u
tiliza
tio
n o
r m
is-
utiliz
atio
n o
f p
resc
rip
tio
n
dru
gs
Un
de
rsta
nd
ing
co
st
sav
ing
s
Op
po
rtu
nitie
s b
ase
d o
n
site
-of-
ca
re (
e.g
.
spe
cia
lty
ph
arm
ac
y v
s.
reta
il p
ha
rma
cy
, fa
cility
vs.
ho
me
)
Ina
pp
rop
ria
te t
he
rap
ies
MAJOR CHALLENGE MEDIUM CHALLENGE MINOR CHALLENGE NOT A CHALLENGE N/A
WHICH ELEMENTS OF THE PHARMACY BENEFIT ARE CAUSING THE MOST DISSATISFACTION AMONG EMPLOYEES?N=13
23%
54%
0%
23%
8%
33% 33%
25%25%
42%
25%
8%
0%
10%
20%
30%
40%
50%
60%
High Dissatisfaction Medium Dissatisfaction Low Dissatisfaction Not Dissatisfied
High Deductibles Increased Premiums Higher cost-sharing
HOW SATISFIED ARE YOU WITH…..N=13
46%
15%
0%
38%
54%
77%
15%
23% 23%
0%
8%
0%0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Your independent consultant Your PBM Your health plan
Highly Satisfied Satisfied Somewhat Satisfied Not Satisfied
WHAT ARE KEY AREAS YOU INCLUDE WHEN DEVELOPING YOUR CONTRACTS? (MARK ALL THAT APPLY)N=13
62%
15%
62%
31%
62%
100%
46%
0%
20%
40%
60%
80%
100%
120%
INDICATE WHICH OF THE FOLLOWING STRATEGIES YOU ARE USING TO ADDRESS HIGH COST DRUGSN=13
0%10%20%30%40%50%60%70%80%
Fu
lly
tra
nsp
are
nt
PB
M
Cu
sto
m e
xc
lusi
on
for
dru
g fo
rmu
lary
Re
fere
nc
e-b
ase
d
pric
ing
Dire
ct
to
ph
arm
ac
y
co
ntr
ac
tin
g
Hir
ing
a
ph
arm
ac
ist
co
nsu
lta
nt
tha
t
wo
rks
for
org
an
iza
tio
n
Dire
ct
co
ntr
ac
tin
g
with
th
e
ma
nu
fac
ture
r
Ou
tco
me
s-b
ase
d
co
ntr
ac
ts
Gro
up
pu
rch
asi
ng
Currently in place Will be in place next 12-24 months Considering for future
Not considering Don’t Know
OPEN DISCUSSION