Latest news with #AsembiaASX25
Forbes
29-04-2025
- Business
- Forbes
Humana's CenterWell Expands Specialty Pharmacy As GLP-1 Drugs Take Off
Humana's CenterWell healthcare services business Tuesday said it would expand beyond its traditional ... More home-delivery pharmacy services business and will begin filling and shipping orders for the popular GLP-1 weight loss drug Wegovy that are prescribed through three telehealth companies: Hims & Hers Health, Inc., LifeMD and Ro. In this photo are images of Novo Nordisk's Wegovy, an injectable prescription weight loss medicine that has helped people with obesity. (Photo by: Michael Siluk/UCG/Universal Images Group via Getty Images) Humana is the latest health insurer to expand into the fast-growing and lucrative business of direct-to-patient specialty pharmacy as demand grows for popular GLP-1 weight loss drugs. Humana's CenterWell healthcare services business Tuesday said it would expand beyond its traditional home-delivery pharmacy services business and will begin filling and shipping orders for the popular GLP-1 weight loss drug Wegovy that are prescribed through three telehealth companies: Hims & Hers Health, Inc., LifeMD and Ro. The partnership was disclosed by Humana and Novo Nordisk that CenterWell Pharmacy will be its fulfillment partner for NovoCare, a pharmacy the drug maker launched a month ago to provide 'direct-to-patient, convenient home shipments of all dose strengths of Wegovy at a reduced cost of $499 per month for cash-paying patients,' Novo Nordisk said last month. CenterWell pharmacy's partnership with Novo Nordisk is directed at cash-paying consumers, or what the industry calls 'self-pay' patients, who don't have health insurance coverage for anti-obesity drugs, which are dropping in price but even with discounts cost several hundred dollars an injection. 'Under the arrangement, CenterWell is helping consumers benefit from reduced cost and convenient access to safe and effective brand-name medications,' CenterWell pharmacy senior vice president Guillermo Sollberger said in a statement released during the annual at Asembia ASX25, which draws more than 8,000 companies tied to the specialty pharmacy industry this week to Las Vegas. The partnership also comes in the wake of the Trump White House's decision earlier this month to scrap a Biden administration proposal to have Medicare health plans for seniors and Medicaid insurance for low-income Americans cover weight loss drugs such as Novo Nordisk's Wegovy. CenterWell and Novo Nordisk see 'direct-to-patient' partnerships as a way to expand access to those without health insurance coverage for certain prescriptions. Novocare follows a similar effort launched last year called LillyDirect, a direct-to-patient effort from Eli Lilly, maker of the GLP-1 drug Zepbound. 'NovoCare Pharmacy is a direct-to-patient delivery option that offers cash-paying patients the GLP-1 medication, Wegovy, at a reduced cost of $499 per month,' Sollberger said. 'Under the arrangement, CenterWell is helping consumers benefit from reduced cost and convenient access to safe and effective brand-name medications.' It's the latest health insurer to expand deeper into specialty pharmacy. Already, UnitedHealth Group's OptumRx and CVS Health, which owns the health insurer Aetna, have expanded more into specialty pharmacy. Optum, for example, has 15 Optum Specialty Pharmacies and two 'Optum Frontier Therapies' that the company says help patients with rare and complex conditions, helping them access more than 200 specialty drugs. And Cigna, which owns Evernorth health services, has expanded its Accredo Specialty Pharmacy since it was part of the company's 2018 Express Scripts purchase and today serves 900,000 patients and ships 7 million prescriptions annually. Meanwhile, And a year ago, Elevance Health, which operates Anthem Blue Cross and Blue Shield plans, a year ago bought the grocery chain Kroger's specialty pharmacy and the year before bought BioPlus. Eventually, drug makers and pharmacies see direct-to-patient models emerging for other new medicines, particularly as technology advances like telehealth that allows Americans to more easily obtain prescription drugs. 'Direct-to-patient distribution models like this are likely to evolve beyond GLP-1s to include other medication categories like migraine therapies and women's/men's health,' CenterWell's Sollberger said. 'CenterWell Pharmacy is well positioned to scale such programs, with the agility to meet the needs of this growing market.'
Forbes
28-04-2025
- Health
- Forbes
Health Plans Brace For Cell And Gene Therapy Costs
Cell and gene therapies are breaking ground as life-saving treatments, but their six- and seven-figure price tags are an increasing worry for employers and healths, according to a new analysis. More than 70% of employers and health plans expect affordability of gene therapy for their health plan members and workers will be a 'moderate or major challenge' over the next 2 to 3 years, according to a report released Monday at Asembia ASX25 in Las Vegas by Pharmaceutical Strategies Group (PSG). The analysis was based on responses from more than 230 health benefits executives from health plans, employers and unions. The report comes with up to a dozen new cell and gene therapies expected to launch on the U.S. market this year, PSG's report said. Such therapies, which can 'prevent or treat a disease by adding, replacing, or turning off genes,' come with high prices such as $475,000 for a treatment for acute lymphoblastic leukemia or more than $3 million for a treatment for hemophilia B. Yet despite the headline-grabbing costs of some of these new treatments, those picking up the tab for the bulk of the costs aren't prepared for potential expenses to their budgets for healthcare. Even though 73% of plans expect cell and gene therapies to 'pose a moderate or major financial challenge in the next 2–3 years, most express low confidence in their understanding of the financial impact,' PSG said in a statement accompanying its report. 'What's more, nearly 40% don't currently use any financial protection product to manage their financial risk related to cell and gene therapies.' 'These therapies aren't one-size-fits-all,' said Renee Rayburg, vice president of clinical strategy at PSG. 'Not only do gene therapies present financial challenges, they're also complex in terms of which patients are eligible as well as the treatment process, and demand is higher for some gene therapies than others. Payers need expert analysis that considers their population, pipeline exposure, and vendor ecosystem.' Specialty drugs already account for well more than half of the total prescription spending any health plan, employer or government health program manages. Employer clients tell benefits consultants specialty costs easily account for 60% or more of their total drug spending, particularly as more Americans flock to anti-obesity GLP-1 medicines, prescriptions hailed for their ability to help people lose weight. But the PSG report says employers are increasingly finding ways to deal with specialty drugs. Take Humira, for example, an expensive rheumatoid arthritis drug derived from biotechnology that at its peak generated more than $20 billion in annual sales as the world's top selling drug for its maker, Abbvie. Humira costs more than $50,00o a patient. But increasingly health plans and employers are covering less expensive biosimilar versions of Humira in a 'preferred position' in their preferred list of drugs known as formularies. The PSG report said '65% of plans have implemented a preferred drug strategy for one or more Humira biosimilars.' 'Leaders are eager to try new approaches to address costs while preserving access to drugs that their members need,' said PSG's chief operating officer, Rebekah Gregg. 'Yet many benefit leaders lack the data, infrastructure, and confidence to fully implement those strategies. Transparency and clear, data- driven insights will be vital to adapt to the pressures payers face.'
