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