Where’s my money?

In an attempt to “take one for the team,” Express Scripts announced “it is introducing a novel formulary (aka Flex Formulary) to provide employers and health plans an opportunity to leverage changing dynamics to help lower their members’ out-of-pocket costs.” Groovy, but wait. According to Drug Channels, there are two possible roadblocks – Problem 1: Many plan sponsors are addicted to rebates and Problem 2: PBMs have rebate guarantees with their plan sponsor clients. “The economics of PBMs and plan sponsors can encourage the use of high-list/high-rebate drugs” and Express Scripts told Drug Channels that some of its clients are “addicted to rebate checks.” Give a hand to Express Scripts for trying something new. For one of the better Family Guy scenes go here and always remember to pay Stewie back (low volume recommended). Enjoy.

Just breathe

According to Robert Pirker, Medical University of Vienna, lung cancer screening by low-dose computer tomography can reduce mortality of smokers or former smokers at high risk for lung cancer. In his opinion, “the results of both screening trials warrant implementation of lung cancer screening in Europe as recommended by several scientific societies.” If you want to know anything about lung cancer, go here. According to the Centers for Disease Control, 218,527 people in the US received a lung cancer diagnosis in 2015. Screening is great and all, but just as an FYI, during 2017, about 249 billion cigarettes were sold in the US. Holy cow, let’s vape. On second thought, according to a new study, there are >7,700 flavors and very few have been tested to toxicity. Not to mention this proposed ban. Ok, that leaves weed…

Drug pricing and the 80/20 rule

According to an analysis conducted by Blue Cross Blue Shield, “expensive branded drugs” accounted for 79% of prescription spending while accounting for just 17% of the prescriptions written. The largest contributors to the 17% came from just 3 drugs: Humira, Remicade, and Enbrel. See a trend? These are all biologic treatments for rheumatoid arthritis (with some Crohn’s Disease sprinkled in). “No sh!+,” said this writer’s mother-in-law who has RA and can’t afford treatment. There are more expensive drugs on the market than these 3 but they tend to treat smaller populations than those with RA and Crohn’s. To be fair (and intellectually honest), the BCBS analysis doesn’t include the impact of rebates, which you just learned 2 articles ago is a big deal. Don’t you retain anything you read? Here’s a list of the top 10 most expensive drugs in the US. Yikes!

Konnichiwa, Dublin

Japan and Ireland have a history of mutual investment and medicine exchange, and an upcoming merger could be the latest and greatest chapter. Osaka-based Takeda announced in May that it would acquire the Dublin-based Shire for $62B, and it looks like its last regulatory hurdle with the EU will be cleared. Unlike these hurdles. Officials are slightly concerned about an IND in Shire’s pipeline that could treat Crohn’s Disease, which would overlap with Takeda’s biggest selling drug Entyvio. But Takeda’s happy to lose that investigational drug if it means closing the deal. After all, the new company would instantly become a global top 10 drugmaker. Keep your head on a swivel though, a few Takeda investors are still against the deal, citing the considerable debt Takeda will have to take on to make the purchase.

Immu-nut therapy

Take two Peanut M&Ms and call in the morning. No really. That’s how one study participant is keeping up his peanut resistance after building it up during a clinical trial designed to test the effectiveness of a peanut allergy protection therapy. Two-thirds of the kids enrolled in the study were able to consume about two peanuts themselves whereas previously they had experienced severe, sometimes life-threatening reactions to even trace amounts. But now, “These kids can eat enough peanut that parents no longer will have to worry about their teenage daughter kissing someone who’s eaten peanut butter.” Good—parents have enough things to be worried about when their teenage daughter is kissing someone without including anaphylaxis. The FDA gave the drug breakthrough therapy status, so you could see it on the market around now in 2019.

Just leveraging an asset

This week the Atlanta Business Chronicle reported that Walmart is looking to create “town centers” in their parking lots that will include things like restaurants, day care establishments, health clinics, and more. To see concept drawings titled “Walmart Reimagined” (sounds very Disney-like), go here. And why not? Walmart is sitting on literally square miles of parking lots. If the parking lots Walmart owns were combined, they’d be larger than Tampa, Florida. The obvious angle for InsightCity readers is the potential for these centers to hold health clinics. Everyone shops at Walmart. Well, not everyone, but 95% of you spent money at Walmart in 2016. We’ve written previous InsightCity articles about the rise of the healthcare clinic (e.g. Minute Clinic) and this, perhaps, is another move in that direction.