As usual, the past year was an eventful one for pharmacy care services. Here are five topics we think helped define 2018.
In 2018 we saw real progress in our efforts to turn back the tide of the opioid epidemic as OptumRx® achieved compelling results from the OptumRx Opioid Risk Management program, a comprehensive framework created to reduce opioid misuse and abuse.
As OptumRx Chief Pharmacy Officer David Calabrese explains, the program deploys five interrelated strategies: prevention and education, minimizing early exposure, reducing inappropriate supply, treating at-risk and high-risk populations, and supporting those in recovery.
During the year, OptumRx clients who adopted the program’s short-acting opioid utilization management edits saw significant improvement in several areas. For example, since the program launch clients recorded a 31% reduction in opioid prescriptions and 34% decrease in in total opioid quantity morphine milligram equivalent (MMEs).
While it was a busy year for specialty pharmacy overall, perhaps no area was more active than oncology. In addition to a new class of drugs for breast cancer, we saw the U.S. Food and Drug Administration approve several new drugs based on a concept called immunotherapy. The idea is simple enough: train the body’s own immune system to identify and kill cancer cells.
However, the enthusiasm surrounding immunotherapy must be balanced against the considerable safety and cost issues the therapy entails. While immunotherapy is currently targeted for a narrow range of cancers, the hope is it will soon be approved for broader indications.
Much as immunotherapy offers new options for treating certain types of cancer, a new class of migraine medications entered the market in 2018. Known as CGRP antagonists, these long-lasting drugs are antibodies that target the physiologic processes underlying migraine.
While CGRP antagonists appear promising, they do come at a substantial cost. Moreover, it has not yet been established that they are any better in terms of efficacy or safety than other currently available therapeutic options from other drug classes. Accordingly, OptumRx has a comprehensive management strategy for the CGRP antagonist class.
The issue of prescription drug pricing has long been a matter of debate. Yet in 2018 the issue became even more high profile as the White House, regulatory bodies and Congress all issued public proclamations on the issue of drug cost.
For some needed perspective, we checked in with Kent Rogers, Senior Vice President, Industry Relations for OptumRx. Responsible for all formulary management and procurement contracting at OptumRx, he explains the market factors contributing to rising prices and the contractual tools OptumRx employs to ensure lower prices for consumers and payers.
Speaking of expensive medications, 2018 gave us a glimpse into a future where the price of certain drugs eclipses $1 million.
Many of the drugs are gene therapies. Working at the genetic level, they offer us entirely new avenues to cure disease. Indeed, the first approved gene therapy in the U.S is intended to cure a hereditary form of blindness.
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