CVS Health Corp, a Major Pharmacy Benefit Manager in the USA Excludes Amgen’s Aimovig from its Covered List of Migraine Drugs while Adding Teva and Lilly’s Drugs in the List


CVS Health Corp, a major US pharmacy benefit manager (PBM) has updated its list of covered migraine drugs by adding migraine drugs from Eli Lilly and Teva Pharmaceuticals and has excluded drug from rival Amgen Inc., according to the CVS spokesperson.

The decision came as a huge setback for Amgen’s Aimovig drug as patients relying on the coverage list will be able to easily access other drugs from rivals Lilly and Teva. The Pharmacy benefit manager acts as an intermediary between insurance companies, manufacturers and consumers by effectively managing drug costs and rebates. The inclusion in the covered list of drugs by the largest PBM’s is very essential and critically important for the sale of new medicines. As patients will prefer the covered drugs rather than the excluded ones, the covered drugs can effectively maximize their sales.

Migraine Research Foundation reports that almost 39 million Americans suffer from migraine. This is a key indicator of existing demand for migraine drugs. The Amgen’s spokeswoman said that the CVS’s decision has caused disappointment, however they will continue to work towards the addition of Aimovig as the preferred brand in the CVS covered drug list.

The share markets responded to the news as Amgen’s shares fell by over 1.3% to $198.27 while Teva’s shares in New York raised by over 1.3% to $19.60 and Lilly traded at $114.36. The CVS decision is a positive news for Teva as it was previously excluded from the coverage list of a leading US PBM Express Scripts. The status has changed now but it may appear on other coverage list with a greater out-of-pocket-cost for customers.

Lilly’s Emgality and Teva’s Ajovy will be now available to patients who have failed to respond well to other migraine treatments. The two drugs belong to a class of CGRP inhibitor drugs which have a proven record of effectively preventing migraines and its prices have been labeled cost-effective by a non-partisan clinical organization Institute of Clinical and Economic Review. The institute specializes in reviewing economic and clinical value of medicines.

Pharmacy benefit managers extract handsome discounts from drug makers for favorable placements in the covered drugs list which involves lower co-insurance or co-payment to their members. A spokesperson for Teva Pharmaceuticals claimed that with the CVS decision, 60% of commercial patients will have access to Ajovy and that they are in talks with major national and regional PBM’s for the addition to their covered lists.

Amgen was the first of the three to launch the CGRP inhibitor drug. All the three drugs have a list price of $6090 per year or $575 per month.


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