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.
Plan includes new 30% manufacturer discount in the US Medicare Part D catastrophic phase, which manufacturers will oppose as too high. But it also caps beneficiary cost sharing, a long-sought industry goal.
The economic stress on payers caused by the pandemic will cause a setback in the development of payment approaches for regenerative therapy, Blue Cross Blue Shield executive warns.