Cubic News

NOC Watch – Jevtana, Zolmitriptan, Benlysta

July 2011

Jevtana® (cabazitaxel injection)

Jevtana® is a new chemotherapy drug recently approved for the treatment of advanced prostate cancer that has become unresponsive to previous hormone therapy.  This drug marks an important achievement for an area in need of clinical advances:  prior to Jevtana®, no drugs had been approved for patients whose cancer had progressed on traditional treatments.  Due to this niche, Jevtana® is sure to gain some attention in the clinical world.

As with most new cancer drugs in the marketplace, Jevtana® is expected to make a substantial impact on plan expenditures given its relatively high cost.  Based on pricing in the UK, it is expected that Jevtana® will cost about $5,700 (CAD) per vial.  With the average patient requiring six cycles for a treatment course (and therefore six vials), the overall expected price will be approximately $34,000 per patient.  Jevtana® is administered as an intravenous infusion every three weeks for a maximum of 10 cycles.

This is a perfect example to demonstrate why plan sponsors should ensure that they are equipped with a well-structured Prior Authorization program for specialty products before drugs like Jevtana® are approved and become an expensive part of the plan experience.

 

Generic Zolmitriptan

Zolmitriptan, a generic formulation for both the regular tablets (Zomig®) and the quick release tablets (Zomig Rapimelt®), has recently been approved as the second generic triptan medication for migraine headaches to come to the Canadian market.  (The first generic triptan available in Canada was sumatriptan for the brand product, Imitrex®.)

Analgesic medications (including migraine headache drugs) were the 7^th most prescribed category of drugs in Canada in 2009.[1]  According to the Cubic Health National Benchmark, triptans alone comprised 1.4% of overall plan spending for the average employer sponsored drug plan in 2010.  Considering that the vast majority of triptans cost over $10 per dose, the release of another generic triptan (zolmitriptan) could translate into modest cost savings for plans. 

References:

[1] Canadian Healthcare Network, RX Chart Toppers: The top prescription drugs in Canada. Mar 2010, Source: IMS Health, IMS Health Canada Databases: Canadian CompuScript Audit (CS), Canadian Drug Store and Hospital Purchases Audit (CDH), and Canadian Disease and Therapeutic Index (CDTI). 2009. 

 

Benlysta® (Belimumab)

Benlysta® is the first biologic approved to treat lupus (a long-term autoimmune condition that can affect the skin, joints, kidneys, brain and other organs), and in fact, is the first drug of any kind to be approved for this disease in over 50 years.  When used in combination with other traditional drugs, Benlysta® has been shown to decrease disease activity, and reduce the need for steroids as anti-inflammatory agents among patients with lupus.

Benlysta® is given as an intravenous infusion biweekly for the first three doses, then given at four-week intervals thereafter, and is expected to have an average annual cost approaching $35,000.  Benlysta® has not yet been studied in patients with more severe forms of lupus in cases where vital organs are affected.  Considering this, and the significant annual cost associated with this new treatment option, plan sponsors should focus on enhancing their Prior Authorization program to not only focus on initiation of coverage, but also continuation of coverage.  This will help ensure that these expensive drugs are being used to treat approved indications at the outset, and that the plan only covers specialty drug claims for those patients with evidence of continued benefit from therapy.

 

 

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