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NEW YORK, April 28 (Reuters) — Express Scripts Holding Co. plans to introduce several benefit programs aimed at fighting high drug costs, including speeding up how quickly it moves insurer and employer customers to cheaper medicines after sudden price hikes, its chief medical officer said.
Express Scripts, the nation's largest pharmacy benefit manager, is discussing the changes with its customers at an annual meeting in Florida today, Chief Medical Officer Steve Miller said in an interview.
Last year, the sudden 5000% price hike by Turing Pharmaceuticals for Daraprim, an anti-infective treatment for a rare disease, caught hospitals and patients by surprise and spurred investigations and hearings in Congress. Drug pricing has since become a national issue, taken up by Presidential candidates Hillary Clinton and Donald Trump.
After that, Express Scripts and its next largest competitor CVS Health found cheaper alternatives for patients, but Express said the new program will make it easier for customers to switch plans quickly.
Express and CVS began several years ago trying to cut spending for customers by narrowing coverage choices and being tougher about patient authorization. This year, CVS also started a specific program to try to limit patient use of expensive dermatology drugs, like Valeant Pharmaceuticals' pricey Jublia toe fungus cream.
Mr. Miller said Express Scripts planned to expand a new pricing scheme in which it pays for cancer drugs based on how well studies show they work for a particular disease. He said it was looking at other therapeutic areas, such as arthritis and inflammatory diseases for 2017.
Rheumatoid arthritis drugs like AbbVie's Humira, Amgen Inc.'s Enbrel and Johnson & Johnson's Remicade are among the top selling drugs in this category and have had large price increases over the years.
Another therapeutic area Express Scripts is watching closely is dermititis, with two new highly-effective drugs potentially hitting the market this year, one from Regeneron Pharmaceuticals . It is also working on diabetes, where it is expecting cheaper treatments to hit the market by the end of the year.
Anthem Inc.'s lawsuit over pharmacy benefit manager Express Scripts Holding Co.'s pricing practices sparks questions about transparency in the PBM industry and what the future may hold for stand-alone PBMs.