Scilex Holding Company Announces New Out-of-Pocket Costs for Commercially Insured Patients
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Insights
The announcement by Scilex Holding Company regarding the cap on out-of-pocket costs for their non-opioid pain management products represents a strategic move to enhance patient access and affordability. From a financial perspective, this approach can potentially increase the volume of prescriptions filled, as lower costs may lead to higher demand. It's important to note that while this may reduce per-unit revenue, the aggregate revenue could increase if the volume uptick outweighs the price reduction.
Moreover, by offering co-pay programs, Scilex may improve medication adherence among patients, which is often a key metric for insurers and can influence formulary placement. Improved adherence can result in better patient outcomes, potentially translating into a stronger market position for Scilex's products. However, the cost of administering these programs must be carefully considered against the potential revenue gains.
Investors should monitor the uptake of Scilex's products following this initiative as well as the company's ability to maintain profitability margins in the face of reduced out-of-pocket costs for patients.
Scilex's decision to cap monthly costs and resolve insurance claim processing issues is a significant development in the competitive landscape of non-opioid pain management. The pharmaceutical market is increasingly sensitive to patient affordability and Scilex's initiative might set a precedent that could pressure competitors to follow suit.
It is also indicative of the company's commitment to addressing barriers to access, which could positively impact brand loyalty and reputation. The timing of this move, with the expected launch of Gloperba in the first half of 2024, suggests a strategic effort to maximize market penetration upon release.
However, the long-term sustainability of such programs will depend on the company's negotiation power with payers and the impact on the overall cost structure. Analysts should assess the broader implications for the industry, including potential shifts in payer strategies and patient expectations.
Scilex's initiative to cap out-of-pocket expenses aligns with broader healthcare policy trends aimed at reducing the financial burden on patients. This move underscores the importance of affordability in healthcare decisions and the role of pharmaceutical companies in addressing it.
From a policy standpoint, such actions can contribute to the overall effort to curb the opioid crisis by making non-opioid alternatives more accessible. While this is a positive development for patients, the impact on health insurance dynamics and the potential for increased premiums should be explored.
Stakeholders, including policymakers, may use this case as a reference point for future regulations or incentives designed to encourage similar practices in the industry. The effectiveness of Scilex's program in improving access without shifting costs elsewhere in the healthcare system will be an important area for ongoing analysis.
PALO ALTO, Calif., March 21, 2024 (GLOBE NEWSWIRE) -- Scilex Holding Company (Nasdaq: SCLX, “Scilex” or “Company”), an innovative revenue-generating company focused on acquiring, developing and commercializing non-opioid pain management products for the treatment of acute and chronic pain, today announced that the out-of-pocket costs for its product portfolio for commercially insured patients is expected to be capped at
Scilex has been working with its co-pay savings card adjudicators to resolve the recent breakdown of processing of insurance claims by Change Healthcare, following a cyber-attack on Change Healthcare. Scilex is aware of the impact this disruption has had on its patients and customers and has worked diligently to resolve the issue. Starting today, co-pay savings card processing for ZTlido® is expected to be restored to normal operations.
Scilex believes that high deductibles and copays shouldn’t prevent anyone from receiving the medications they need. Scilex co-pay programs is designed to help patients reduce their co-pays and out-of-pocket costs for their medication. Our program partners with various assistance programs to help make a patient’s medication affordable.
For more information on Scilex Holding Company, refer to www.scilexholding.com
For more information on ZTlido® including Full Prescribing Information, refer to www.ztlido.com.
For more information on ELYXYB®, including Full Prescribing Information, refer to www.elyxyb.com.
For more information on Gloperba®, including Full Prescribing Information, refer to www.gloperba.com.
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About Scilex Holding Company
Scilex Holding Company is an innovative revenue-generating company focused on acquiring, developing and commercializing non-opioid pain management products for the treatment of acute and chronic pain. Scilex targets indications with high unmet needs and large market opportunities with non-opioid therapies for the treatment of patients with acute and chronic pain and are dedicated to advancing and improving patient outcomes. Scilex’s commercial products include: (i) ZTlido® (lidocaine topical system)
In addition, Scilex has three product candidates: (i) SP-102 (10 mg, dexamethasone sodium phosphate viscous gel) (“SEMDEXA™” or “SP-102”), a novel, viscous gel formulation of a widely used corticosteroid for epidural injections to treat lumbosacral radicular pain, or sciatica for which Scilex has completed a Phase 3 study and has granted Fast Track status from the FDA in 2017; (ii) SP-103 (lidocaine topical system)
Scilex Holding Company is headquartered in Palo Alto, California.
Forward-Looking Statements
This press release and any statements made for and during any presentation or meeting concerning the matters discussed in this press release contain forward-looking statements related to Scilex and its subsidiaries under the safe harbor provisions of Section 21E of the Private Securities Litigation Reform Act of 1995 and are subject to risks and uncertainties that could cause actual results to differ materially from those projected. Forward-looking statements include statements regarding the expected out-of-pocket costs for commercially insured patients, the expectation that co-pay savings card processing for ZTlido will be restored, Scilex’s expectation to launch Gloperba® in the first half of 2024 and plans to initiate a Phase 2 clinical trial in 2024 for SP-104.
Risks and uncertainties that could cause Scilex’s actual results to differ materially and adversely from those expressed in our forward-looking statements, include, but are not limited to: risks associated with the unpredictability of trading markets and whether a market will be established for Scilex’s common stock; general economic, political and business conditions; risks related to COVID-19 (and other similar disruptions); the risk that the potential product candidates that Scilex develops may not progress through clinical development or receive required regulatory approvals within expected timelines or at all; risks relating to uncertainty regarding the regulatory pathway for Scilex’s product candidates; the risk that Scilex will be unable to successfully market or gain market acceptance of its product candidates; the risk that Scilex’s product candidates may not be beneficial to patients or successfully commercialized; the risk that Scilex has overestimated the size of the target patient population, their willingness to try new therapies and the willingness of physicians to prescribe these therapies; risks that the outcome of the trials and studies for SP-102, SP-103 or SP-104 may not be successful or reflect positive outcomes; risks that the prior results of the clinical and investigator-initiated trials of SP-102 (SEMDEXA™), SP-103 or SP-104 may not be replicated; regulatory and intellectual property risks; and other risks and uncertainties indicated from time to time and other risks described in Scilex’s most recent periodic reports filed with the Securities and Exchange Commission, including Scilex’s Annual Report on Form 10-K for the year ended December 31, 2023, including the risk factors set forth in those filings. Investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this release, and Scilex undertakes no obligation to update any forward-looking statement in this press release except as may be required by law.
Contacts:
Investors and Media
Scilex Holding Company
960 San Antonio Road
Palo Alto, CA 94303
Office: (650) 516-4310
Email: investorrelations@scilexholding.com
Website: www.scilexholding.com
SEMDEXA™ (SP-102) is a trademark owned by Semnur Pharmaceuticals, Inc., a wholly-owned subsidiary of Scilex Holding Company. A proprietary name review by the FDA is planned.
ZTlido® is a registered trademark owned by Scilex Pharmaceuticals Inc., a wholly-owned subsidiary of Scilex Holding Company.
Gloperba® is the subject of an exclusive, transferable license to use the registered trademark by Scilex Holding Company.
ELYXYB® is a registered trademark owned by Scilex Holding Company.
All other trademarks are the property of their respective owners.
© 2024 Scilex Holding Company All Rights Reserved.
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