Today we want to take a couple of minutes to go over the drug pipeline, what we can anticipate in the future, as well as think about some strategies to have in place to help manage those new medications. If you are unfamiliar, the drug pipeline is the set of potential drug candidates that a pharmaceutical company has under discovery or development at any given point in time.

Overall, specialty drugs have been a key driver in the past couple of years and will be in the future as well. This is due to manufacturers being heavily invested in it, as well as this is where a majority of the new drugs are being approved.

Curious what the drug pipeline in 2021 looks like? One of our Pharmacy Consultants, Bibek Sandhu, shares more in the video below:

One of the key therapy areas will be the NASH drugs as they come to the market. Currently, there are new FDA-approved products. One of the first agents that are likely to be approved is obeticholic acid, and it is seeking approval this month, June 2020.

As these drugs come to market, our health plans and our clients will begin to think about what we can have in place to help manage these. So, some of those key strategies will be UM strategies, making sure the right patients are getting the right agent, and working with your specialty providers to have clinical management in place as well.

Another key therapy area that has been important for the past couple of years and that has been driving pharmaceutical trends is cancer therapy agents. As of this date, the FDA has approved around 22 novel agents and 10 of those have been in the cancer area. This will not be something that is going away. We will likely see more products come to the market in the future. Again, plans will need to have the right strategies in place like UM and make sure the right patients are getting these products.

Another therapy area that is and will be important are the gene and cell therapy agents. By 2023 we are anticipating 60 of these products will be on the market. Plans will need to think about not just the clinical criteria, but also how they are going to pay for these products.

We don’t anticipate that the traditional reimbursement models are going to work well for these considering the price of these products. Our health plans and clients are going to need to think about how they are going to pay for these. Are they going to be some part of the risk pool? Where you will be covered if you have a patient or member on this product. Or maybe some payment over time strategy? Where you potentially work with a specialty provider that pays for the drug upfront and then you arrange how it will be paid for over a set period of time.

The last class and therapy area that is going to be important, especially in helping to lower pharmacy spending and trends, is going to be the biosimilars. They have been slow to come to the market, especially in the U.S., however, we do anticipate this to change and we will see more of the products in the future.

Plans and clients need to think about how they will have a biosimilar strategy. One of the key challenges we have seen in the biosimilar space has been getting providers to switch over to these products so that is going to be a key part of that strategy doing academic detailing to make the providers in your community feel comfortable switching to these biosimilars.

Overall, those are some of the things we are working with our clients and anticipate will be key in the future, when it comes to the drug pipeline. If you have any questions or would like help managing your pharmacy benefits and are having some challenges. We are here for you! Feel free to reach out to one of our pharmacy benefit consultants!