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Strategies for ensuring access to clinically appropriate insulin or other medications
Expenses for those with diabetes add up. A patient with diabetes may have up to twice the health care costs as someone without diabetes
Whether a plan member with diabetes needs insulin or a different medication, our formularies focus on providing a low net cost strategy while ensuring clinical appropriateness. To complement our formulary strategies, we use weekly new-to-market (NTM) reviews to assess new drugs, whether they are biologic, biosimilar, traditional brand or generic drugs.
When evaluating NTM biosimilar products for inclusion on our formulary, we review clinically appropriate alternatives in their therapeutic class. Sometimes the lowest net cost product is the reference brand and sometimes it is the biosimilar. Of biosimilars that have launched, we have several preferred biosimilars on our commercial template formularies.
A generic drug uses the same active ingredients as the biologic drug and is considered the reference product’s bioequivalent
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Depending on each state’s laws, a pharmacist may be able to substitute an interchangeable biosimilar for the reference product at the pharmacy without a prescriber or member request.
The FDA has approved 30 biosimilars
The FDA has approved
1 is approved
The FDA has approved
Insulin glargine-yfgn is both a biosimilar to and interchangeable with its reference product Lantus (insulin glargine). While insulin glargine-yfgn is the first interchangeable biosimilar product approved in the United States for the treatment of diabetes, it is also the first interchangeable biosimilar product approved by the FDA.
The manufacturer expects to launch the product before the end of 2021.
Approval of interchangeable biosimilars, such as insulin, can provide effective additional products for consideration by providers, creating opportunities for us to drive lowest net cost for our clients and make drugs more affordable for members.
The source for data in this document is CVS Health Enterprise Analytics, unless otherwise noted.
This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Health.
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