CVS Health Helps Customers Accelerate Biosimilar Adoption Through Formulary Changes - Supporting Affordable Options for Osteoporosis Care
What is a drug formulary?
A drug formulary is a continually updated list of preferred medications and related products supported by current evidence-based medicine, judgment of physicians, pharmacists and other experts.
How does CVS Caremark help customers use a formulary to drive savings?
CVS Caremark helps customers use a formulary to help manage costs while making sure that their members have access to clinically appropriate medications. In much the same way that generic drugs are used as alternatives to branded drugs, biosimilars offer quality, safe, and effective treatment options that have no clinically meaningful difference from their reference products.
How is CVS Caremark helping to improve the use of biosimilars?
This formulary change builds on steps Caremark previously took to exclude reference brand Humira from its template formulary and include lower list price biosimilars.
"Caremark was the first pharmacy benefit manager to exclude reference brand Humira from our commercial template formulary in favor of biosimilars priced dramatically less than the branded product," said
CVS Caremark has proven experience in supporting biosimilar adoption, helping 96% of Caremark's client members using Humira to transition to a biosimilar.
How is CVS Specialty making care simpler?
Like Humira and its biosimilars, Prolia is a specialty drug dispensed by CVS Specialty. As is done for all CVS Specialty patients who experience changes to their plan formulary, CVS Specialty proactively reaches out to both the prescriber and the patient to inform them about the formulary change, describe the process for providers to submit a new prescription for a covered alternative and keep the patient updated about the process.
"When a CVS Specialty patient's plan formulary changes, our advanced technology capabilities allow us to streamline the process for the doctor by communicating with them in their electronic health record workflow and sending a new prescription that can be approved with a single click," said
What are biosimilars and what do these biosimilars treat?
Biosimilars are often injectable medications that treat complex chronic conditions and require special handling such as temperature control. These factors make drug shortages and supply chain issues particularly challenging for biosimilars and underscore the importance of a reliable supply of medication for the patient.
The Prolia biosimilar options now included on Caremark's template formulary are Ospomyv, brought to market by
Ospomyv and Stoboclo are FDA-approved for the treatment of osteoporosis in high-risk individuals, as well as increasing bone density in men and women undergoing certain cancer treatments. Treating osteoporosis is crucial to prevent painful and debilitating fractures, which can lead to loss of independence, disability, and even death, particularly in older adults. These effective alternatives for osteoporosis offer patients affordable options with the same clinical benefits—increasing access to lifechanging medications.
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