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PBM Formulary Exclusions In Oncology Are On The Rise

Physician-Administered Drugs Make Up Nearly Half Of Oncology Exclusions

 
• By Cathy Kelly

Oncology drugs are no longer immune to pharmacy benefit management formulary exclusions in the commercial market and even drugs administered in a physician’s office are increasingly being subjected to rebate-driven coverage decisions.

Growing Competition Among Cancer Drugs Has Opened The Door To Exclusions • Source: Alamy

The leading US pharmacy benefit managers have significantly increased the number of oncology drugs subject to commercial formulary exclusions over the past five years and, notably, physician-administered drugs made up nearly half of the exclusions in the PBMs’ 2021 national drug lists, according to a new white paper from IQVIA.

“In a market like oncology where it has long been common belief that payers are unwilling to exert control, today...

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Lilly CEO Ricks Advocates Rebalancing Drug Pricing Between US And Europe

 
• By Mandy Jackson

As President Trump focuses on “most favored nation” pricing to bring down US drug costs, CEO David Ricks used Lilly’s Q2 earnings call to advocate for a slow approach to reducing the difference between US and EU drug prices.

Pharma Is Cooperating With Trump On Direct Sale To Consumers, Bourla Says

 
• By Jessica Merrill

Pfizer is in active discussions with Trump on MFN pricing and collaborating with peers on direct sales as an approach to lower drug prices, CEO Bourla said.

Most Favored Nation Pricing: Trump Ups Pressure On Voluntary Action, Clarifies Demands

 
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The new 60-day deadline for striking a deal with the drug industry underscores the challenges the Administration may be having in developing non-voluntary policies to achieve MFN pricing in the US.

Sanofi CFO Says Direct Sales To Patients ‘Certainly Worth Considering’

 
• By Kevin Grogan

François Roger believes fixing inefficiencies is more important than playing with pricing.

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Xenon Nears Phase III Readout For Potential Epilepsy And Depression Blockbuster

 
• By Andrew McConaghie

Leading a field of rival potassium channel modulators, azetukalner will have a pivotal epilepsy readout early next year, with Phase III trials in depression and biopolar disorder also underway.

Stock Watch: Sanofi And Merck Temper Big Pharma Q2 Earnings Cheer

 
• By Andy Smith

The investor enthusiasm that greeted initial second-quarter pharma earnings announcements was dampened by the results from Sanofi and Merck & Co. Sanofi was particularly punished by investors despite overall growth, while Merck’s revenue fall was probably baked into expectations.

Japan Results Roundup: Reduced Forex Impact, Uncertain US Tariff Outlook

 
• By Lisa Takagi

Most major Japanese firms report generally positive fiscal first quarter results, led by mainstay growth and despite lower currency effects. But the future impact of any US pharma tariffs remains an overhang.