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UnitedHealth Group is joining the ranks of insurers opting to prioritize cheaper versions of drugs over their name-brand counterparts.
A bulletin sent to customers seeking client feedback explained the nation’s largest insurer will be changing its reimbursement terms for drugs like long-acting insulins, reported Reuters.
Sanofi’s Lantus will no longer be a part of the coverage plan. UnitedHealth will instead switch it with Eli Lilly’s biosimilar insulin Basaglar. Novo Nordisk’s Levemir was downgraded from a Tier 1 plan to Tier 2.
Another change-up occurred with Amgen. The company’s white-blood cell boosting drug Neupogen won’t be part of the coverage plan next year. Novartis’ biosimilar Zarxio will be its replacement, but the Swiss drug maker will see its leukemia therapy Gleevec be removed from this list and have the generic version made by Sun Pharma rise in its place.
It’s not all bad news for some of the pharmaceutical firms.
“Some drugs–such as multiple sclerosis treatments from Novartis, Sanofi and Biogen–will get a boost. Seven MS drugs that were previously excluded–as was Biogen’s Plegridy–or otherwise restricted will be freely available. These include Biogen’s Tecfidera, Novartis’ Gilenya and Sanofi’s Aubagio, three of the new generation of oral treatments,” wrote FierceBiotech.
Plus, UnitedHealth will take a proactive step in changing coverage plans based on trends like overprescribing. As an example, it changed its pain-drug coverage by dropping Purdue’s OxyContin and two other opioids in order to adhere to new CDC guidelines while also contending with an increase in pharmaceutical advertising.
This revamp is part of a growing trend. CVS Health and Express Scripts both changed their formularies to include the most cost-effective options for patients as drug prices continue to rise. Healthcare systems in the U.S. and Europe could save billions over the next few years by adopting these cheap medications into health plans.
UnitedHealth’s updated formulary will go into effect next year.
Filed Under: Drug Discovery
