2017 Trends in Medication Management – Cory Cowan.

Content Outline

I. Therapy class review 2017
II. Legislative updates
III. Biosimilars
IV. Drug pipeline highlights

Hepatitis C retreatment

Objective

  • To determine if products are achieving similar results in real world as in clinical trials

Approach/methods

  • Looked at continuously eligible claimants from 2013-2017
  • 2nd regimen identified as >=12 week lag from completion of first regimen

Findings

  • Retreatment rates higher in 2013-14 (~15%) but for last 2 years <5% and continuing
    to decline; newest agents <1% (however, may be due to less follow-up)

Conclusions

  • Appears SVR rates have been sustained long-term in clinical practice
  • Confirmed benefit for patients and payers

Hepatitis C ongoing surveillance

Potential UPWARD pressure

  • Pan-genotypic agents (Epclusa)
  • Removal of fibrosis score criterion
  • Long-term retreatment potential (Vosevi)
  • Expansion to other patient populations (HIV)
  • New Focus on Hepatitis B?

Potential DOWNWARD pressure 

  • Lower cost entrants (Maviret)
  • Declining pool of eligible patients
  • High SVR rates approaching 100%; low potential for retreatment
  • Shorter durations of treatment
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