February 2 RxAdvocate August, 2022 — Newsletter
August Stories:
- Dobbs vs. Jackson
- FDA Approves First Vitiligo Therapy
- Consolidated Appropriations Act
Dobbs v. Jackson
On Friday, June 24th, 2022, the U.S. Supreme Court issued its decision in the Dobbs v. Jackson Women’s Health Organization case in which it effectively overturned the 1973 abortion rights decision in Roe v. Wade. There are several implications with this decision that could directly impact access to various medications and employer sponsored group pharmacy benefit plans.
Currently, if a plan is fully insured, whether the pharmacy plan can cover medications pertaining to abortions will likely depend on the law of the state where the policy was issued. However, if the plan is self-insured and subject to the Employee Retirement Income and Security Act (ERISA), it generally is not subject to state insurance laws due to ERISA preemption. Thus far, ERISA preemptions have protected self-insured plans from civil liability; however, it is unknown whether that preemption will apply to criminal actions. This factor plays a large role in the ability of a pharmacy benefit plan to include or exclude coverage for abortifacient medications.
FDA Approves Ruxolitinib Cream – First Vitiligo Therapy
The Food and Drug Administration (FDA) approved the first and only treatment for non-segmental vitiligo in adult and pediatric patients, Ruxolitinib (Opzelura) 1.5% cream. Vitiligo is an autoimmune disease that occurs when the immune system attacks melanocytes, the cells responsible for producing pigment. Non-segmental vitiligo is the most common form of the disease affecting 9 out of 10 people with the disorder. The study that led to FDA approval of ruxolitinib cream found at 24 weeks a significantly greater proportion of patients receiving ruxolitinib showed a 75% improvement from baseline in the facial vitiligo area scoring Index (F-VASI75) and greater than or equal to 50% improvement from baseline in total body VASI (T-VASI50) when compared to the placebo cream.
Consolidated Appropriations Act
Consolidated Appropriations Act
In November 2020, the federal government issued a regulation requiring health plans and health insurers to publish prescription drug pricing and cost information monthly online, and provide plan members a prescription drug cost-comparison tool. This will promote transparency in rebates and pricing year over year. This will also provide insight into what is driving Rx spending, how rebates impact premiums, and out-of-pocket costs, and allow greater transparency into Rx drug pricing.
The Consolidated Appropriations Act was signed into law on December 27, 2020.
Plans must first report data by December 27, 2022.
Your Pharmacy Benefit Manager will reach out to you directly on next steps and what will be submitted.
Contact us
Visit us on the web at www.rxconnectionllc.com.
If you would like additional information on our services please contact:
Orlando Neal — Principal
Orlando.Neal@rxconnectionllc.com
Orlando.Neal@rxconnectionllc.com