CVS Formulary Drops Drugs With “Egregious” Price Hikes

Company leans toward biosimilars and follow-on biologics

CVS Health has announced that it is taking a stand against “egregious” drug price increases that unnecessarily add costs for clients and their members. Among the “hyperinflationary” drugs that will be removed from its 2017 formulary is Alcortin A external gel (1% iodoquinol/2% hydrocortisone acetate/1% aloe polysaccharides) by Novum Pharmaceuticals, which saw a nearly thirtyfold price jump in the last three years.

In total, CVS has barred 131 medications from its aggressive 2017 formulary listing. Almost one-third of those products had prices that went up dramatically in recent months.

The 10 “hyperinflationary” drugs knocked off the formulary this time include products from serial price-hike offender Valeant Pharmaceuticals and its fellow Canadian drugmaker, Concordia Healthcare. Both have come under fire recently for huge price hikes.

CVS said “no” to Valeant’s Zegerid, a heartburn drug, and DexPak, which is the steroid drug dexamethasone in taper-off dosage packaging. Zegerid combines the generic ingredient omeprazole with sodium bicarbonate (common baking soda), and dexamethasone is available as a generic.

Concordia had two drugs dropped from the CVS list: Nilandron (nilutamide) for prostate cancer and Dutoprol (metoprolol succinate extended release and hydrochlorothiazide), a combination medication for hypertension.

Novum Pharma had three drugs kicked off the formulary, including Alcortin A external gel, the dermatology treatment that CVS cited in its announcement. The price of that product went up by more than 2,800% over the past three years, CVS said.

CVS is also taking steps to address “limited-source generics,” which are products with limited generic manufacturers, resulting in significant costs in the market. CVS said it will evaluate these products and, if appropriate, exclude them during the year.

CVS is including biosimilars and follow-on biologics as a key component of its 2017 standard formulary strategy, replacing higher-cost drugs within the categories. This will include the biosimilar Zarxio (filgrastim-sndz, Sandoz), replacing Neupogen (filgrastim, Amgen), to decrease the risk of infection in patients receiving treatment for certain forms of cancer, and the follow-on product Basaglar (insulin glargine injection, Eli Lilly)—approved in Europe as a biosimilar––replacing Lantus (insulin glargine injection, sanofi-aventis) for the treatment of diabetes.

Starting on January 1, 2017, CVS will apply an indication-based strategy to help contain hepatitis C treatment costs. According to the company, indication-based formularies provide a more precise management strategy based on a drug’s treatment indication or diagnosis and on the value that the therapy delivers to each individual patient.

Sources: FiercePharma; August 3, 2016; and CVS; August 1, 2106.