Bridging the gap between the hospital and alternate-site care Volume 2 • Number 3 • Summer 2013 • specialtypharmacycontinuum.com
In This Issue Clinical
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URAC executive makes the case for SP accreditation.
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Strategies for fixing a fragmented health care system.
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Multiple sclerosis: oral and injectable agents square off.
Savings With Biosimilars: A Promise Yet To Pay Off
Advances in multiple myeloma therapies.
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Technology
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Tips for ensuring cold-chain product integrity.
Operations & Mgmt
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Home infusion can take the strain off busy EDs.
Policy
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Where are we on the biosimilars approval pathway?
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10 Elements payors should look for in a specialty pharmacy
The View From The Payor Side Las Vegas—How are health plans approaching the growing specialty spend? Burt Zweigenhaft, CEO of OncoMed360 and the moderator of a panel on payor perspectives at this year’s Armada Specialty Pharmacy Summit, put that question to a group of industry experts after leading with a perspective of his own: “Whenever they say it’s not about the money, it’s all about the money.” Costs are definitely a driver for payors, and the changing landscape resulting from health care reform, and particularly the rise of accountable care organizations
Disease State Spotlight
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Managing specialty spending:
Orlando, Fla.—National drug spending could be cut by $250 billion between 2014 and 2024 if only 11 biosimilar versions of current best-selling biologics are approved during those 10 years, Express Scripts has forecasted (www.lab.express-scripts.com). The company’s vice president of research and analysis, Sharon Frazee, said her team’s projection is based on a “uberconservative” model and suggested the savings could even be higher. “There are 92 patent expiries coming up,” said Ms. Frazee. “We only included the 11 that we believe are certainly going to have competitor biosimilars come to market.” The analysis, which was presented at the Express Scripts Outcomes Symposium, compared a scenario in which 11 generic versions of current best-selling
biologics (Table, page 22) would be available between 2014 and 2024 with one in which only the branded biologics would be available. In the biologics-only scenario, spending on the 11 drugs was estimated to increase from $33.6 billion in 2014 to $121 billion in 2024. In contrast, if the 11 biosimilars included in the other scenario were to receive FDA approval, spending in 2024 would be $81.3 billion, Express Scripts predicted. The cumulative savings between 2014 and 2024 would be $250 billion if these 11 biosimilars were approved, Express Scripts estimated (Figure, page 22). Although the savings could be higher than the forecast predicts, Molly Burich, MSc, a market analyst not involved in the research, said in an interview that
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see SPENDING, page 24
Accreditation Initiative Gets Mixed Reviews
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ommunity pharmacies—including those that provide specialty pharmacy services—will soon face the decision of whether to become accredited by the Center for Pharmacy Practice Accreditation (CPPA), by URAC, or to forgo accreditation, at least for now. Supporters of the new push for accreditation claim it will raise the overall quality of the profession, whereas opponents argue it is duplicative of existing state and federal laws, and overly burdensome in terms of cost, time and effort. This area began to heat up last summer, when both URAC (formerly known as the Utilization Review Accreditation Commission) and CPPA, the most recent entrant into the accreditation arena, held
see BIOSIMILARS, page 22
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see ACCREDITATION, page 18
The Book Page 2013 Oncology Pharmacy Preparatory Review Course
FDA Watch
ACCP
Denosumab (Xgeva, Amgen) gets new indication
See Page 27.
See page 9.