Magellan Rx Medical Pharmacy Solution Impact: 90% of New Authorizations for Oncology Biosimilars

Rhea-AI Summary

Magellan Rx Management, a division of Magellan Health (NASDAQ: MGLN), announced preliminary results from its oncology biosimilar medical pharmacy solution. As of May 2020, health plan customers that partnered with Magellan achieved a 90% authorization rate for initial therapies with biosimilar availability. This program, developed in early 2019, comes amid rising oncology biosimilar market entries. Potential savings from biosimilars are estimated at a minimum of 15%, with further results expected in early 2021, as oncology drugs account for a significant share of specialty pharmacy expenses.

Positive

• 90% authorization rate for new oncology biosimilars indicates strong market uptake.
• Expected savings of at least 15% for health plan customers using the biosimilar program.
• Ten oncology biosimilars have launched since the program's inception, enhancing treatment options.

Negative

• None.

Magellan Rx Management, a division of Magellan Health, Inc. (NASDAQ: MGLN), today released preliminary results from its oncology biosimilar medical pharmacy solution that targets new-to-market oncology therapeutic biosimilars. These results further demonstrate Magellan Rx Management’s innovative capabilities and expertise in the specialty drug market. As of May 2020, health plan customers who were quick to partner with Magellan Rx have achieved a 90% rate for authorization for the first two therapies with biosimilar availability. In early 2019, Magellan Rx developed a management program designed to prepare customers, members, and providers for the market entry of oncology biosimilars ahead of their availability in July 2019. Since then, ten oncology biosimilar agents have launched in the United States.

Magellan Rx Management (Graphic: Business Wire)

“These results, less than one year after implementation, highlight Magellan Rx’s passion and commitment to developing forward-thinking, industry-leading solutions to manage one of the most complex and evolving areas of healthcare—medical pharmacy drug spend,” said Steve Cutts, PharmD, senior vice president and general manager, specialty, Magellan Rx Management. “Given our 17-year history in medical benefit management, combined with innovative comprehensive oncology solutions and our prior success in advancing biosimilar utilization, we are uniquely qualified to support our health plan customers to deliver true savings while maintaining or expanding member access to clinically-effective, lower-cost treatments.”

Health plan customers implemented this program throughout the fall and winter of 2019, shortly after the July 2019 arrival of oncology biosimilars on the market, with several more opting into this innovative program through early 2020. The 90% rate is measured by the number of authorizations approved for the biosimilars compared to the reference brands. Due to the cost differential between oncology biosimilars and their reference brands, savings are expected to be at least 15%,¹ but could be greater depending on plan benefit design and other factors. As oncology and oncology support drugs continue to be the largest driver of specialty pharmacy spend on the medical benefit—43% of total medical drug spend for both the Commercial and Medicaid populations and 55% in Medicare²—and given the billions of dollars that are spent on these treatments, significant additional savings are anticipated with full results expected in early 2021.

To learn more about how Magellan Rx Management’s solution can increase the use of less-expensive biosimilars, view this poster that was presented at the Academy of Managed Care Pharmacy Annual Spring Conference in April 2020. For more information on the oncology biosimilar landscape, watch this webisode of MRx Events @ Home featuring one of our in-house specialty experts, Rebecca Borgert, PharmD, BCOP, senior director, clinical strategy and programs.

1. Amgen Inc. (2019) Amgen And Allergan's MVASI™ (bevacizumab-awwb) And KANJINTI™ (trastuzumab-anns) Now Available In The United States [Press release]. 18 July. Available at: https://www.amgen.com/media/news-releases/2019/07/amgen-and-allergans-mvasi-bevacizumabawwb-and-kanjinti-trastuzumabanns-now-available-in-the-united-states/ (Accessed: 26 August 2020).
2. 2019 Magellan Rx Management Medical Pharmacy Trend Report™, ©2020.

About Magellan Rx Management: Magellan Rx Management, a division of Magellan Health, Inc., is a next-generation pharmacy organization that is delivering meaningful solutions to the people we serve. As pioneers in specialty drug management, industry leaders in Medicaid pharmacy programs and disruptors in pharmacy benefit management, we partner with our customers and members to deliver a best-in-class healthcare experience.

About Magellan Health: Magellan Health, Inc. is a leader in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of accessing better health through technology, while remaining focused on the critical personal relationships that are necessary to achieve a healthy, vibrant life. Magellan's customers include health plans and other managed care organizations, employers, labor unions, various military and governmental agencies and third-party administrators. For more information, visit MagellanHealth.com.

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FAQ

What are Magellan Health's oncology biosimilar program results as of May 2020?

Magellan Rx Management reported a 90% authorization rate for the first two therapies with biosimilar availability.

What potential savings can health plans expect from Magellan's biosimilar program?

Health plan customers may anticipate savings of at least 15% from the oncology biosimilar program.

How many oncology biosimilars have launched in the U.S. since 2019?

Since the program's launch in July 2019, ten oncology biosimilar agents have entered the U.S. market.

When will additional results from Magellan's biosimilar program be available?

Full results from the oncology biosimilar program are expected in early 2021.

What percentage of specialty pharmacy spend do oncology drugs represent?

Oncology and oncology support drugs account for 43% of total medical drug spend for Commercial and Medicaid populations and 55% in Medicare.