Month: July 2025

The FDA recently approved a new therapy, Emrelis (telisotuzumab vedotin-tllv) from AbbVie, indicated for the treatment of adult patients with locally advanced or metastatic non-squamous non-small cell lung cancer (NSCLC) with high c-Met protein overexpression, as determined by an FDA-approved test, who have received a prior systemic therapy.

Emrelis represents a significant breakthrough in the targeted treatment landscape for lung cancer. This novel therapy functions as an antibody-drug conjugate (ADC) with a c-Met-directed mechanism, combining the precision of antibody targeting with the potency of a microtubule inhibitor. Administered exclusively via infusion, Emrelis stands as the inaugural therapy of its kind specifically approved for this group of patients. Its approval, however, may require future trials that confirm its clinical benefit.

Approximately 85% of lung cancers are classified as NSCLC and, despite advances in treatment, lung cancer remains the leading cause of cancer-related deaths. Emrelis is a first-in-class c-Met-directed antibody-drug conjugate (ADC) that targets c-Met expressing cells.

Emrelis is administered intravenously every 2 weeks until disease progression or unacceptable toxicity.

Emrelis launched at a wholesale cost of $13,980 for a 100-milligram vial and $2,796 for a 20-milligram vial. Including step-down dosing at induction, the annual cost of therapy will run ~$400,000.

The company did not disclose any details related to distribution.

CLICK HERE to access prescribing information

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U.S. FDA Approves EMRELIS™ (telisotuzumab vedotin-tllv) for Adults With Previously Treated Advanced Non-Small Cell Lung Cancer (NSCLC) With High c-Met Protein Overexpression

CLICK HERE to access the press release

Congressional hearings on PBM practices don’t seem to be doing much yet to ‘fix’ the multitude of problems with PBMs. And, payers nationally have been desperately searching for solutions that offer a better deal for the health plan as well as the patient.

In a bold move, Blue Shield of California (BSCA) took an unprecedented step in 2023: it announced the end of its partnership with CVS Caremark, its traditional pharmacy benefit manager. Rather than replace CVS with another single PBM, BSCA unveiled a pioneering strategy—partnering with a diverse group of companies, each bringing a specialized business model to the task of managing and delivering pharmacy benefits.

Among these new partners are Amazon Pharmacy, Abarca Health, Mark Cuban Cost Plus Drug Company, and Prime Therapeutics, each chosen for their proven expertise in targeted areas. This collective effort was christened the “Pharmacy Care Reimagined Initiative.” The ambition behind the initiative is nothing short of transformative:… to disrupt the established PBM landscape by allocating responsibilities to companies that excel in distinct, specialized roles. For example, Abarca Health now handles drug claims, while Evio Pharmacy Solutions negotiates outcome-based contracts.

BSCA’s vision is guided by a clear objective—to ultimately save $500 million in Rx spend every year.

But what gives this program its unique edge? They say the answer lies in the power of data and technology. BSCA is leveraging information that extends well beyond standard clinical data supplied by manufacturers. By harnessing real-world evidence and advanced analytics, they empower smarter, more holistic decisions. A specialized partner—an expert company focused on this very task—provides the engine driving these data-driven insights.

This sophisticated system now makes it possible for BSCA to make patient-centered, cost-effective decisions spanning the entire spectrum of benefits. It enables meaningful comparisons between medical and pharmacy courses of care, fostering an integrated approach, benefit-wide strategies that prioritize both cost savings, and better health outcomes for members.

In reimagining the future of pharmacy benefits, Blue Shield of California is charting a course that could inspire the entire industry to think bigger, act bolder, and always put patient needs at the center.

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Divide To Conquer. Blue Shield of California Is Spreading Out Its Pharmacy Benefit Management

CLICK HERE to read the full article

There is a professional organization for nearly every segment of health care, each typically publishing papers and articles on their specific area of focus. These publications are invaluable sources of information that also enable us to produce our Reports.

Recently, we have concentrated on cell and gene therapy due to significant advancements and activity within this field a segment of great interest for manufacturers, and payers alike. This sector has seen the emergence of new companies, technological breakthroughs, and even cures for certain diseases.

In this context, we introduce the American Society of Gene and Cell Therapy (ASGCT). Notably, ASGCT recently hosted their Annual Meeting in New Orleans. Unlike many annual gatherings, it is highly likely that the various presentations were well attended, given the rapid pace of developments in this field. Every scrap of new research or new technology could hold substantial value.

The accompanying article is recommended for a brief read to pique your interest. It highlights how several companies are positioning themselves to revolutionize the industry, moving towards a future where personalized, effective treatments for complex diseases are increasingly attainable. We will be on alert for other articles tackling the other remaining, thorny issue….. affordability.

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Gene and Cell Therapies in Focus at ASGCT 2025: Tackling Rare Diseases, Autoimmune Conditions, and More

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In recent weeks, we have issued reports highlighting cell and gene therapy from various perspectives. Another area of research under the same umbrella is stem cell therapy, which shares many similar challenges but warrants specific attention.

Today’s article serves as an excellent primer for health professionals to understand the unique aspects of stem cell development and its potential to introduce groundbreaking technologies for modifying or even curing diseases.

What exactly does stem cell therapy aim to achieve? Stem cells have the ability to develop into any type of cell found in the human body. Essentially, this indicates that stem cells may be implanted to replace lost cells, offering potentially transformative treatments for a wide range of diseases and conditions.

The article addresses the development of a particular stem cell therapy for Parkinson’s disease. However, it also explores the fundamental issues common to stem cell research, including:
How can stem cell therapy treat diseases?
Clinical trials: Recent stem cell therapy studies that show significant promise
A “big leap” in treatment development
Causes of Parkinson’s disease and current therapeutic approaches

Researchers concur that stem cell therapy still has a long journey before becoming a widespread reality; however, the level of optimism appears to be growing.

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The stem cell race for Parkinson’s disease: Recent studies show significant promise

CLICK HERE to access the full article

Today our spotlight is on how well a gene therapy approved in early 2024 has performed with a lookback at several years preapproval and over a year post launch.

The specific therapy is not the primary focus of this report. Rather, it serves as an example to assess whether a therapy truly performs as advertised.

This ‘one-and-done’ therapy was introduced at a price of $3.5 million. The pre-approval trial results were exceptionally favorable, meeting the aspirations of any manufacturer. The outcomes were so impressive that the manufacturer confidently offered insurers a warranty providing “financial protections” in case the therapy failed to deliver as promised or even if its efficacy did not persist. It is important to note that the trials were relatively small for this orphan therapy, further challenging the confidence level of good outcomes in a larger population.

It is uncommon to encounter such positive feedback as the following:

·    After the first year, no treatment-related adverse events were reported.

·    Of the nine serious adverse events documented in four participants, none were related to the treatment.

·    There was no discontinuation or dropout from the study resulting from adverse events or death.

·    No participant resumed legacy therapy during the trial.”

A comprehensive review of the article could serve as a benchmark for any manufacturer aiming to achieve excellence in the launch of new drugs.

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Multiyear Follow-up Study Shows Positive Results for Hemophilia B Gene Therapy

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A fog of uncertainty hangs thickly in the air. Manufacturers find themselves wringing their hands in the aftermath of sweeping layoffs and shifting policies at the Department of Health and Human Services, the FDA, and elsewhere.

The article that follows shines a spotlight on a single program emblematic of this collective anxiety: the pediatric priority review voucher initiative, now among the earliest casualties of fiscal cutbacks. One might expect that a program championing treatments for rare and orphan pediatric diseases would win easy favor in the political arena—yet even such causes can be ground to dust in all the political meat grinding.

The fate of voucher programs at large remains uncertain, casting a long shadow. The article notes a particular complication: “Despite widespread support, the priority review program faces some opposition – especially regarding companies redeeming vouchers for drugs outside the rare disease sphere; critics maintain these incentives should be reserved solely for treatments targeting rare conditions.”

Ultimately, as ever, it all boils down to finances. With the program’s future hanging in the balance, investors hesitate, less willing to commit resources amidst the ongoing uncertainty.

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FDA Layoffs and Priority Review Program’s Lapse Disrupt Rare Disease Pipeline

The expiration of the FDA’s pediatric priority review voucher program is creating uncertainty for rare disease drug developers.

CLICK HERE to access the full article

Orphan Drugs are significantly impacting the health care market. A recent independent report analyzes the key market elements and challenges, providing some guidance to pharmaceutical companies and payers on developing strategies for survival and growth.

The report indicates that the orphan drug market is experiencing robust growth due to increased awareness, improved diagnostics, advancements in biotechnology, and supportive government policies. Financial incentives such as market exclusivity, tax credits, and grants continue to encourage pharmaceutical companies to develop treatments for rare diseases.

Moreover, leading factors driving this growth include heightened awareness, advancements in diagnostics, biotechnology, and supportive government policies and programs. The orphan drug pipeline is expanding, particularly with Cell and Gene therapy candidates, despite high development costs, limited patient populations, and regulatory challenges. Notably, demand in emerging global markets is having a significant reciprocal impact on the global market.

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Orphan Drugs Market Size to Expand at a CAGR of 9.7% During the Forecast Period of 2024-2030

CLICK HERE for more detail on the referenced report

The FDA recently approved a new indication for an infused therapy, Uplizna (inebilizumab-cdon) from Amgen. While the therapy was originally approved in 2020, this approval elevates Uplinza in the specialty pharmacy category as it is now the first and only therapy approved for adults living with Immunoglobulin G4-related disease (IgG4-RD). IgG4-RD is a chronic and debilitating immune-mediated inflammatory condition that can affect multiple organs.

In an NIH study, the incidence of IgG4-RD was 1.39 per 100 000 in the USA in 2019. That translates into ~3500 people with an IgG4-RD diagnosis in 2025. Uplizna was granted a breakthrough drug status.

IgG4-RD can occur in multiple organs and lead to fibrosis and permanent organ damage. Patients will take two initial loading doses followed by infusions every six months, leading to an annual cost of $280,497 after the first year.

Amgen did not release any details related to distribution.

CLICK HERE to access prescribing information

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Uplizna (Inebilizumab-Cdon) Is Now the First and Only FDA-Approved Treatment For Igg4-Related Disease

CLICK HERE to read the full press release

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