- Programs & Services
- Cost Management
- Specialty Management
- Care Management
- Member Engagement
- Health Plan Client Engagement
Payors Need Effective Utilization Management to Mitigate Spend Impact
Specialty Pharmacy Pipeline | Drugs to Watch
Anticipated Launches | Q1 – Q2 2021
Atopic dermatitis (AD), which is a type of eczema, is one of the most common diseases in the Western world.
What is Atopic Dermatitis?
|AD is a chronic, inflammatory skin disease without a cure.
|Onset is at an early age.
|Many patients have trouble controlling their recurring AD.|
|Those with severe AD are more likely to have an urgent care, emergency department, or hospital visit than those with moderate AD.
Evolving Treatment Landscape
Topical therapies have been the mainstay of AD treatment.
First Specialty Drug
Regeneron’s Dupixent (dupilumab), approved by the U.S. Food and Drug Administration (FDA) in 2017, hinders the interleukin-4 and interleukin-13 (IL-13) cytokines.
Notable Potential 2021 Approvals
Janus Kinase Inhibitors
New Molecular Entity
Pfizer’s once-daily oral treatment, abrocitinib, received Priority Review from the FDA with an April 2021 decision date set. The Janus kinase (JAK) inhibitor Breakthrough Therapy targets moderate to severe AD for those 12 and older.
The FDA approved Olumiant (baricitinib), a JAK inhibitor oral treatment, in 2018 to treat rheumatoid arthritis (RA). Eli Lilly and Incyte are seeking approvals for Olumiant in March 2021 to treat adults with moderate to severe AD.
In 2019, Rinvoq (upadacitinib) received FDA approval to treat RA. AbbVie applied in October 2020 for FDA approval — with an April 2021 decision expected — for Rinvoq, a JAK inhibitor and Breakthrough Therapy, as a treatment for those 12 and older with moderate to severe AD. Rinvoq is a once-daily oral medicine.
Incyte is pursuing approval of a cream of ruxolitinib, a new formulation of a JAK inhibitor for patients with mild to moderate AD 12 years and older.
Interleukin Antagonist/Monoclonal Antibody
Tralokinumab, a new biologic from Leo Pharma, is expected to receive FDA approval to treat adults with moderate to severe AD in May 2021. Tralokinumab, administered subcutaneously every two weeks, is a fully human monoclonal antibody focused on blocking the IL-13 cytokine.
Managing Utilization, Containing Costs
With new treatments — including a new biologic and two Breakthrough Therapies — expected to shake up the atopic dermatitis landscape in 2021, payors should carefully consider appropriate cost and utilization management to mitigate spend.
|Formulary strategies that mitigate the impact of drug prices, such as drug removals, indication specific coverage, and outcomes-based contracting.|
|Specialty Guideline Management (SGM) includes clinical assessments based on FDA labeling, current clinical guidelines for standard of care and evidence-based medical literature, and day-one review of new-to-market drugs.|
|Enhanced SGM incorporates utilization management strategies such as prior use of non-specialty drugs, limiting coverage to select diagnoses and promoting less costly, therapeutically equivalent therapies.|
|Quantity limits help ensure dosages dispensed do not exceed the upper limit of safe and appropriate thresholds based on each drug’s FDA-approved dosing limits.|
Note: This article was corrected after publishing to clarify that Incyte is the manufacturer of ruxolitinib. Eli Lilly is not involved.
Data source, unless noted otherwise, CVS Health Enterprise Analytics, 2021.
This page contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Health.
Image source: Licensed from Getty Images, 2021.