SCOTTSDALE, Ariz.--(BUSINESS WIRE)--
Magellan Rx Management, the pharmacy benefit management (PBM) division of Magellan Health, Inc. (MGLN), today announced the launch of a medical pharmacy solution targeting oncology therapeutic biosimilars. In preparation for the expected 2019 market entry of oncology biosimilars, the solution aims to educate customers, members and providers through the implementation of individualized strategies that consider clinical, financial and regulatory factors. This will ultimately result in maintaining or expanding member access to clinically-effective treatments, while having the added benefit of delivering significant drug spend savings for participating customers.
As a leader in managing medical benefit oncology drug spend, Magellan Rx has focused on advancing biosimilar utilization since 2015, empowering customers to turn biosimilar availability into cost savings while maintaining clinical quality. Building on the success of the Company’s recently announced medical pharmacy program focused on biosimilar versions of a high-cost autoimmune therapy, the expanded medical pharmacy solution is designed specifically for oncology biosimilars and involves three key components:
- Proactive Management: Assessing and developing clinical protocols while educating and communicating with network oncologists
- Medical Pharmacy Execution: Leveraging Magellan Rx’s innovative oncology medical management expertise by incorporating biosimilars into key utilization management programs such as medical prior authorization and provider reimbursement/fee schedule management
- Expert Opinion: Continuously working to gain insights from our oncology advisory board and Expert Clinical Network of key opinion leaders
“Magellan Rx is preparing our health plan customers for the upcoming entrance of biosimilars to the oncology category and helping them take advantage of cost savings, while ensuring clinical efficacy and safety, as quickly as possible after the launch of these products,” said Kristen Reimers, RPh, senior vice president, specialty clinical solutions. “Our oncology biosimilar initiative takes a multi-pronged approach, including the establishment of plan-specific goals, robust provider education and outreach, and partnership with our customers with the goal to maximize potential savings, minimize disruption, and improve outcomes for patients.”
Keeping Pace with the Pipeline
The U.S. Food and Drug Administration has reported that biological products are the fastest-growing class of therapeutics.1 Entrance of oncology therapeutic biosimilars marks an increase in competition that will have an impact on the landscape in this category. According to the 2018 Magellan Rx Medical Pharmacy Trend Report, oncology agents make up 34 percent of the total medical pharmacy spend for commercial plans.2
The three oncology brands with expected biosimilar availability in 2019 make up $9 billion in U.S. drug sales, and almost $50 million in annual drug spend per one million covered commercial lives.2 Magellan Rx is projecting savings to be $5-$8 million per one million covered lives, but there is potential for even greater savings based on Magellan Rx’s past successes with biosimilars. The opportunity is even more compelling for the Medicare population, where spend for the same three drugs is almost double at over $90 million per one million covered lives.2
For more on forecast and trends in the oncology category, watch our video here.
- Biosimilar and interchangeable products. Food and Drug Administration. 2018. http://www.fda.gov/Drugs/DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/ApprovalApplications/TherapeuticBiologicApplications/Biosimilars/ucm580419. Accessed 2019 Mar 21.
- 2018 Magellan Rx Management Medical Pharmacy Trend ReportTM, ©2019.
About Magellan Rx Management: Magellan Rx Management, a division of Magellan Health, Inc., is a full-service, next-generation pharmacy benefit manager (PBM) that helps our customers and members solve complex pharmacy challenges by connecting them to the people, technology, and information they need to make smarter healthcare decisions. As experts in managing specialty spend both on the prescription and medical benefit, we are energized by discovering new and better ways to deliver solutions in today’s complex and rapidly-evolving healthcare environment, leading people to live healthier, more vibrant lives.
About Magellan Health: Magellan Health, Inc., a Fortune 500 company, is a leader in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of accessing better health through technology, while remaining focused on the critical personal relationships that are necessary to achieve a healthy, vibrant life. Magellan's customers include health plans and other managed care organizations, employers, labor unions, various military and governmental agencies and third-party administrators. For more information, visit MagellanHealth.com.