UnitedHealth trims drug
coverage, including Sanofi insulin
Send a link to a friend
[September 22, 2016]
(Reuters) - UnitedHealth Group, the largest U.S. health insurer,
will stop covering several brand-name drugs as of next year, reinforcing
a trend of payers steering prescriptions to lower-priced options.
In a bulletin seeking client feedback by Sept. 28, UnitedHealth said
it is changing reimbursement terms for long-acting insulins and will
no longer cover Lantus, the main insulin drug sold by Sanofi.
The insurer said Basaglar, a cheaper biosimilar insulin sold by Eli
Lilly would be covered as "Tier 1," meaning the lowest out-of-pocket
costs for members. Levemir, produced by Novo Nordisk, will move from
Tier 1 to Tier 2.
CVS Health made similar move last month to drop Lantus in favor of
Lilly's new biosimilar.
Analysts at Jefferies said the sales impact of the United exclusion
should be less than that from the CVS move, because the United plan
covers around 15 million people while CVS covers 19 million.
Sanofi shares fell more than 1 percent on Thursday after the news
but had recovered by 0955 GMT, while Novo was down 1.2 percent.
Biosimilars are cheaper copies of protein-based biotech drugs such
as Lantus, which are no longer protected by patents. They cannot be
precisely replicated like conventional chemical drugs but have been
shown to be equivalent in terms of efficacy and side effects.
United also said it will exclude from coverage Amgen's white blood
cell-boosting drug Neupogen, in favor of Zarxio, a biosimilar sold
[to top of second column]
UnitedHealth last year bought Catamaran for $12.8 billion, making it
the nation's No. 3 pharmacy benefit manager after Express Scripts
Holding and Caremark, which is owned by CVS.
(Reporting by Deena Beasley and Ben Hirschler; Editing by Marguerita
[© 2016 Thomson Reuters. All rights
Copyright 2016 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.