Otezla Formulary Wins

only the beginning. damn, wish I was good enough to have made second interview.

Otezla in a Variety of Formularies
While Otezla's PsA launch is young, Otezla has found a place in many formularies besides the previously mentioned PBMs. Review dates vary by plan and most referenced dates describe when the formularies were last updated.


https://medicare.kaiserpermanente.org/.../2014/compre...

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1May2014 Tier like biologics

http://www.primetimehealthplan.com/Application/813/getForm.aspx

26Jun2014 Tier 5 like biologics

https://swp.mvphealthcare.com/wps/wcm/connect/1244047d-6405-4f9a-b976-70d674fb9a9c/Medicaid_Option_and_Option_Family_Prescription_Drug_Formulary_Effective_January_1_2014.pdf?MOD=AJPERES

1Jun2014 Tier 3 like biologics (tier 3 is highest in this plan)

https://www.healthpartners.com/ucm/groups/public/@hp/@public/documents/documents/cntrb_042473.pdf

Jul2014 Tier 5

https://www.excellusbcbs.com/wps/wcm/connect/1039ca24-64ef-4a24-9b0c-cc3003169ebe/B-1907+CHP++Formulary+-+WEB_5.14.pdf?MOD=AJPERES&CACHEID=1039ca24-64ef-4a24-9b0c-cc3003169ebe

May2014 Prior authorization, quantity limited

http://blue.regence.com/trgmedpol/drugs/dru342.pdf

1Jun2014 Prior authorization, quantity limited

http://chccarolinas.coventryhealthcare.com/web/groups/public/@cvty_regional/documents/webcontent/c105696.pdf

Tier 3 of 3 https://www1.ghc.org/static/pdf/medicare-2014/comprehensiveformulary14.pdf

25Jun2014 Tier 4 of 4

http://www.primetherapeutics.com/pdf/July2014_BCBSNCFormularyUpdates.pdf

9Apr2014 Tier 4 of 4

http://www.priorityhealth.com/provider/manual/auths/drug/formulary-updates/may-2014

1Jul2014 Non-preferred, prior authorization, quantity limited

http://www.txvendordrug.com/formulary/FormularyDetails.asp?Item=59572063106

9Apr2014

www.networkhealthmedicare.com/_files/pdf/2014_Formulary.pdf

1Jul2014 Tier 4 Non-preferred versus Tier 5 for biologics

http://www.optimahealth.com/medicaredocuments/Medicare_Drug_List_Formulary.pdf

6Jun2014 Tier 5 like biologics

https://cathealthbenefits.cat.com/cda/files/404922/7/

1May2014 Tier 3 of 3

http://www.kpshealthplans.com/pharmacy/druglists/KPS-drug-formulary.pdf

Jun2014 Tier 3 of 3 versus Tier 2 for biologics

https://www.bcbsri.com/sites/default/files/2014BMEDGroupFormulary6-1.pdf

1Jun2014 Tier 4 of 4 like biologics

http://unityhealth.com/intranet/groups/pubweb/documents/unity_nativefile/ui_007121.pdf

16Jun2014 Tier 3 of 3 Humira/Enbrel Tier 2, other biologics and Xeljanx Tier 3

http://www.healthspan.org/uploads/forms/oh_comprehensive_formulary_june_HealthSpan.pdf

1Jun2014 Tier 5 like biologics

https://mp.medimpact.com/brandcontentprovider/OGB/MP/AUG_2014_OGB_Alphabetical_Formulary.pdf

Aug2014 Tier 4 of 4 like biologics

https://www.univeracommunityhealth.org/wps/wcm/connect/fbe25cd2-608c-40fd-bb92-d8e9cc88a7fc/UN_1004_FHP_PlusMed_Formulary_UN_WEB_5.1.14.pdf?MOD=AJPERES

May2014 Brand, prior authorization, quantity limited

http://www.uphp.com/wp-content/uploads/2014/02/UPHPPlus_ComprehensiveFormulary.pdf

1Jul2014 Tier 5 like biologics

http://www.hfs.illinois.gov/assets/pdl.pdf

1Jul2014 Non-Preferred like biologics except Preferred Cimzia, Enbrel, Humira

http://www.tricare.mil/uniformformulary

27May2014 Tier 3 of 3

http://www.regencerx.com/learn/priorAuth/idahoPriorAuth.html

5Jun2014 Non-Preferred like biologics except Preferred Cimzia, Enbrel, Humira

http://www.shpnc.org/library/pdf/board-materials/may-2014/13p-t-summary.pdf

30May2014 Double step requirement

http://benefits.umich.edu/forms/formulary.pdf

1Jun2014 Tier 2 of 3 like biologics

https://dc.fhsc.com/downloads/providers/DCRx_PDL_listing.pdf

1Jul2014 Requires prior authorization like biologics except preferred Enbrel, Humira

https://www.cignaclientresources.com/GetFile.ashx?fileId=331

1Jul2014 Non-preferred like biologics except Enbrel, Humira

https://www.cignaclientresources.com/GetFile.ashx?fileId=331

Jun2014 Tier 3 of 3 like biologics except Enbrel, Humira

 

Settle down little fella. These formulary wins are nothing. They just give access to the product.

The coming tsumani for biologics, including future IL options, is when the PBMs use APR as a wedge between DMARDS and biologics.

In the future, you will still have to try and fail an DMARD simply due to economic pressure. Then you will have to step edit through APR to get to biologics.

Let me repeat. Much like today where you must use DMARDS before TNFs, very soon you will have to use APR BEFORE, again BEFORE biologics.

Now, let the stock grow.

Been here in HEM for over 7 years and I really only need about another 18 months and I will retire at 52.

Been a good run.

 

I am on the HEM side as well and couldn't be prouder of what we see going on.

Whoever is writing otherwise is fake.

 

Its on Tricare and the VA as well.

Why wouldn't someone want to give an oral option a chance that has virtually no side effects after week 2? Oh, and it's oral. And its $5k-$30k cheaper.

If it doesn't work, they could always try a biologic.

I don't get why they wouldn't? Of course I am just an Investor Village contributor, not an MD and not a detail man.

 

They wouldn't because it doesn't work.

 

Would you pay $25,000 for a bottle of sugar pills? Because I wouldn't. And that is why Otezla is not, nor will it ever be, a step before biologics. MAYBE if it were 90% cheaper than it is, but not at $25,000. It simply is not cost effective to put a patient on an overpriced drug that does not work. If I am going to pay 5 figures for a drug, it will be for a drug that WORKS.

 

An insurance company looks at efficacy data to make it's decisions. They need fact based evidence that 1 molecule is truly superior over another. I thin Otezla has a market and could fit into the market but at the right price. Celgene is used to charging a lot of money for their cancer drugs because that is the market. Same thing with I & I however it is not of the same efficacy, bottom line you could be a first or second line at the appropriate price.

 

Nobody pays 5 figures for a drug you tool!

 

Same drunk and unemployed moron that keeps saying it's 25k, that's how you know since it's 22.5k and says it doesn't work when actually the efficacy is really good vs the side effect profile and everyone agrees. Why risk taking something like humira that works for two years and causes infections? Rather take that as a last resort and not first line considering the efficacy goes down over time. Also the payers are happy since this is I believe around 11k a year more. Why not wait??? It works and it's selling, go find a job

 

Ok you apparently missed my point and I'm not the unemployed moron. I simply said, as someone with formulary & contract experience and no not contract rep, insurance contracts. You have to boast a better efficacy for ok let's split hairs here, a $22.5k per year treatment. I can see with your listening and comprehension skills you'll fare nicely in your national ranking.

 

Hahahaha. Your hammered! Can you break down the safety and efficacy? Duration of treatment ??? You are not a payer. A buyer. The FDA. Or a SELLER!!!!

 

Simple questions : is safety of importance? And do you think the safety profiles of ANY PSA drug compare to Otezla???

 

You can't build a blockbuster with just safety.

 

Yes, safety is important and yes Otezla has a cleaner side effect profile but I've heard the clinicals show similar efficacy to topical treatments.
Are those your opening questions? Your probes? What will you do when they ask "does it work?" When spinning your clinicals how will you sidestep that most topical so had same clearance?

 

Topical treatments for PSA??? Give it up, read the label and get a job.

 

Again you imbecile, if you are talking PSorasis , some topical treatments are known to work, but for how long??? Otezla can be taken safely for years and efficacy is shown to increase over time (not decrease like the competition ). You are a joke, forget what you "hear" considering you don't have a job and try READING the information if you can. Also, try and learn a few basic concepts like "risk vs reward" and "duration of treatment"

 

Good luck! If someone on cafepharma gets under your skin this badly to where you resort to name calling and assumptions on their employment and how that relates to their literacy I think you'll do well with handling objections.

 

Caremark CVS
http://www.caremark.com/portal/asset/z6500_drug_list807.pdf


Catamaran
https://www.catamaranrx.com/uploadedFiles/Documents/Physicians_Page/CF220_CATAMARAN%20ADVANTAGE%20COMPREHENSIVE%20FORMULARY_5.1.2014_v.1.pdf

load up the truck - longs still being rewarded

how ya like me know, little fella?

 

Right, because no one is intelligent enough to differentiate how to act with a customer vs am imbecile on an anyonmous website. No wonder you didn't get the job. These "objections" aren't even real ones

 

Please, please don't engage little fella. Let him finish his nap.

Each of his arguments is proven false:

sales - booming
access - ever increasing
ability of the commercial team - widely recognized in early surveys with rheums…derm surveys have not yet been sent
willingness of the BOD to support I&I - committed to every press conference, earning report, telecast, etc - they are in this for the long haul - look at the patent protection and the earnings capability(you do know that the profits on this molecule approach 99% given that its a small molecule vs the biologics average of 75%).
every whine about the severance package shows he is not a current employee
his drunken time of day postings
his ability to post in the middle of the day when most productive workers are, wait for it….at work

put the pacy back in and roll over little fella