Insurers pushing back against “me too” drugs

  • According to Reuters, a small little-known group of experts who advise U.S. health insurers on new drugs says that none of the three new migraine drugs offers a clear benefit over drugs already on the market, suggesting that they could consider them for optional coverage (which would limit their use).
  • Insurers have also signaled that a lot of the new immunotherapy cancer drugs may also face significant hurdles unless they show a clear benefit of drugs lredy on the market.

How many PDL-1 cancer drugs do we need on the market? Unfortunately when one drug succeeds other drug companies tend to want a slice of the pie and develop “me too” drugs but some insurers are starting to say “enough is enough.”

Some new drugs have conducted clinical trials against drugs already on the market. It can be risky but if you show an advantage over current products you may have an edge in marketing and insurance coverage.

Three recently approved migraine medications, Amgen’s Aimovig , Eli Lilly’s Emgality and Teva Pharma’s Ajovy, all priced at ~$7,000, will apparently face stiff challenges on pricing from UnitedHealth Group’s pharmacy benefit manager (PBM) OptumRx. Why approve drugs that show no clear benefit over competitors already on the market?

While PhRMA touts the development of new drugs in the pipeline, they don’t bother to mention that many are “copycat” drugs. This is what happens when innovation is replaced by an attempt to please investors and Wall Street.

How many diabetes drugs do we need and are patients confused by all the drugs on the market? My instinct tells me “yes” which is why so many drugs promote their unique benefit in DTC such as “losing weight.” Is there a big difference between Keytruda and Opdivo? Not to Oncologists.

We can expect a lot more “me too” drugs because the balance sheets are too important.