by Jane Anderson
A new generic alternative
for GlaxoSmithKline’s Advair Diskus (fluticasone/salmeterol) provides payers
with the chance to better manage care in chronic obstructive pulmonary disease
(COPD), a condition in which high out-of-pocket costs often lead to lower compliance
and an increased risk of hospitalization.
Advair Diskus, a
combination long-acting beta-agonist and an inhaled corticosteroid, has been
one of the most common drugs used for COPD, a condition largely dominated by
brand products. The generic, marketed by Mylan and approved Jan. 30, joins
generics for two additional COPD devices: a generic for Ventolin HFA
(albuterol) and one for Proair HFA (albuterol).
All three have the
potential to save payers and patients significant money. Charline Shan, R.Ph.,
vice president, access experience team at payer insights and strategy firm
Precision for Value, says plans have multiple options for structuring their
formularies with the amount of generic options available.
Generics are typically
included, with brand drugs placed on preferred or nonpreferred tiers based on
price, "but not all are required or have to be on the formulary since
there are many branded and therapeutic equivalent options," she says.
Most people with COPD are
covered by Medicare, and CMS requires that a minimum of two products for each
category or class be available on the formulary. However, Medicare Part D plans
may also consider additional factors when structuring their formularies for
COPD patients, including the total cost of care, and that may lead them to
implement more selective branded choices on formularies than commercial plans,
Shan says.
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