Rare Diseases and Orphan Products Accelerating Research and Development (2010) / Chapter Skim
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Appendix C: Medicare Part D Coverage and Reimbursement of Orphan Drugs
Appendix C: Medicare Part D Coverage and Reimbursement of Orphan Drugs
Pages 309-344
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From page 309... ...
1 The Orphan Drug Act of 1983 defines an orphan indication as follows: "in the case of a drug, any disease or conditions which (A) affects less than 200,000 persons in the United States, or (B)
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However, the Social Security Compassionate Allowances program -- 2 Although the NORD report notes the tier placement and utilization management tools used for each drug, the authors do not provide any analysis of these aspects of drug coverage.
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From page 311... ...
-- these plans are currently referred to as "Medicare Advantage Plans." The Medicare Prescription Drug Improvement and Modernization Act of 2003 created the Medicare Part D program, a voluntary drug benefit that is administered through private health plans or pharmaceutical benefit managers. As of January 1, 2006, Medicare beneficiaries could voluntarily enroll in either a stand-alone PDP or a Medicare Advantage plan with prescription drug coverage (MA-PD)
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From page 312... ...
: specialty drugs6 • Tier Each tier has a different cost sharing requirement -- most plans assign a flat copayment to the first three tiers and a coinsurance to the specialty tiers (although a growing number of plans are requiring a coinsurance for the first three tiers)
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METHODS Medicare Part D Plans Characteristics and Orphan Drug Coverage We used the CMS Formulary and Pharmacy Network Information File (January 2010 quarterly release) to determine the coverage, tier placement, and utilization management requirements for each orphan drug.
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These categories are subjective and were created only to simplify the interpretation of the results for all drugs along the three dimensions of access (i.e., plan coverage, tier placement, and utilization management)
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List of Orphan Drugs We created a list of drugs that were approved by the FDA with an orphan indication between 1983 and December 2008. We included only drugs approved prior to 2009 in order to provide adequate time for marketing and plan coverage decisions.
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From page 316... ...
for orphan drugs among Medicare prescription drug plans is high. On average, an orphan drug is covered by 84 percent (standard deviation: 24 percent)
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Overall, MA-PD plans have slightly better coverage of orphan drugs than stand-alone PDPs. Compared to PDPs, the percentage of drugs falling into the no-very low and low-coverage categories is slightly lower among MA-PDs (4 percent in MA-PDPs versus 7 percent in PDPs)
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Stand-alone PDP Trade Coverage (% plans Route of Orphan Designation(s) Generic Name Name that cover drug)
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Conversely, 19 of the 95 covered drugs are covered by less than 50 percent of the nonnational plans. Formulary Tier Placement by Stand-Alone PDPs The orphan drugs are commonly placed on high cost sharing tiers.
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From page 320... ...
TABLE C-5 Orphan Drugs by Rate of Prior Authorization Use and Type of Medicare Prescription Drug Plan (95 drugs) Stand Stand- Stand- alone Stand- alone alone Non Stand- alone Non- Bench- bench alone MA- National national mark mark PDPs PDPs PDPs PDPs PDPs PDPs N (%)
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From page 321... ...
, and whether there are any utilization management requirements for the drug. In terms of the percentage of plans that cover the drugs, Medicare prescription drug plan coverage of orphan drugs is relatively extensive.
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From page 322... ...
Although most orphan drugs are covered by PDPs, patients who require drugs that are placed on high cost sharing tiers are forced to either pay large out-of-pocket costs or forgo treatment. The cost-related and utilization management-related nonadherence for orphan drugs among the Medicare population is not known.
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From page 323... ...
Exclusivity Indication for Original Approvala Start Date Generic Name Trade Name 10/3/84 Cromolyn sodium Opticrom 4% Treatment of vernal 4% ophthalmic ophthalmic keratoconjunctivitis solutionb solution Naltrexone HClb 11/30/84 Revia For blockade of the pharmacological effects of exogenously administered opioids as an adjunct to the maintenance of the opioid-free state in detoxified formerly opioid-dependent individuals Potassium citrateb 8/30/85 Urocit-K (1) Prevention of calcium renal stones in patients with hypocitraturia.
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From page 324... ...
, postencephalitic Parkinsonism, and symptomatic Parkinsonism 12/22/89 Cromolyn sodium Gastrocrom Treatment of mastocytosis 10/2/90 Citric acid, glucono- Renacidin Treatment of renal and bladder calculi delta-lactone irrigation of the apatite or struvite variety and magnesium carbonatec Calcium acetateb 12/10/90 Phos-lo Treatment of hyperphosphatemia in end-stage renal failure 12/26/90 Altretamine Hexalen Palliative treatment of patients with persistent or recurrent ovarian cancer following first-line therapy Sotalol HClb 10/30/92 Betapace Treatment of life-threatening ventricular tachyarrhythmias 11/25/92 Atovaquone Mepron For the acute oral treatment of mild to moderate Pneumocystis carinii pneumonia in patients who are intolerant to trimethoprim-sulfamethoxazole 12/23/92 Rifabutin Mycobutin Prevention of disseminated Mycobacterium avium complex disease in patients with advanced HIV infection Interferon beta-1bc,d Betaseron 7/23/93 In ambulatory patients with relapsing remitting multiple sclerosis to reduce the frequency of clinical exacerbations Megestrol acetateb 9/10/93 Megace Treatment of anorexia, cachexia, or an unexplained significant weight loss in patients with a diagnosis of acquired immune deficiency syndrome 9/23/93 Lodoxamide Alomide Treatment of ocular disorders tromethamine ophthalmic referred to by the terms vernal solution keratoconjunctivitis, vernal conjunctivitis, vernal keratitis 3/7/94 Desmopressin N/A Treatment of patients with hemophilia acetateb A or von Willebrand's disease (type I) whose factor VIII coagulant activity level is greater than 5%
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APPENDIX C TABLE C-A1 Continued Exclusivity Indication for Original Approvala Start Date Generic Name Trade Name Pilocarpineb,d 3/22/94 Salagen Treatment of symptoms of xerostomia from salivary gland hypofunction caused by radiotherapy for cancer of the head and neck 5/31/94 Rifampin, isoniazid, Rifater For the short-course treatment of pyrazinamide tuberculosis 6/30/94 Aminosalicylic acid Paser granules Treatment of tuberculosis infections Sulfadiazineb 7/29/94 N/A Toxoplasmosis, as adjunctive with pyrimethamine 8/15/94 Cysteamine Cystagon Treatment of nephropathic cystinosis in adults and children Amiodarone HClb 8/3/95 Cordarone For initiation of treatment and prophylaxis of frequently recurring ventricular fibrillation and hemodynamically unstable ventricular tachycardia in patients refractory to other therapy Tretinoinb,d 11/22/95 Vesanoid Induction of remission in patients with acute promyelocytic leukemia who are refractory to or unable to tolerate anthracycline-based cytotoxic chemotherapeutic regimens Riluzoleb,d 12/12/95 Rilutek Treatment of patients with amyotrophic lateral sclerosis 4/30/96 Sodium Buphenyl Adjunctive therapy in the chronic phenylbutyrated management of patients with urea cycle disorders involving deficiencies of carbamylphosphate synthetase, ornithine transcarbamylase, or argininosuccinic acid synthetase Interferon beta-1ac,e 5/17/96 Avonex Treatment of relapsing forms of multiple sclerosis to slow the accumulation of physical disability and decrease the frequency of clinical exacerbations 5/17/96 Allopurinol Aloprim for Management of patients with sodiumb,c injection leukemia, lymphoma, and solid tumor malignancies who are receiving cancer therapy that causes elevations of serum and urinary uric acid levels and who cannot tolerate oral therapy Ofloxacinb 5/22/96 Ocuflox Treatment of bacterial corneal ulcers ophthalmic solution continued
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From page 326... ...
8/23/96 Somatropin for Serostim Treatment of AIDS wasting or cachexia injectionc,e Midodrine HClb 9/6/96 Amatine Treatment of symptomatic orthostatic hypotension 9/26/96 Pentosan polysulfate Elmiron Relief of bladder pain or discomfort sodium associated with interstitial cystitis 10/25/96 Betaine Cystadane Treatment of homocystinuria Tizanidine HClb 11/27/96 Zanaflex Treatment of spasticity associated with multiple sclerosis and spinal cord injury Glatiramer acetatec 12/20/96 Copaxone For reduction of the frequency of relapses in patients with relapsing remitting multiple sclerosis 1/28/97 Zinc acetate Galzin For maintenance treatment of patients with Wilson's disease who have been initially treated with a chelating agent Anagrelideb 3/14/97 Agrylin Treatment of patients with essential thrombocythemia Toremifened 5/29/97 Fareston Treatment of metastatic breast cancer in postmenopausal women with estrogen positive or receptor unknown tumors Ursodiolb 12/10/97 Urso Treatment of patients with primary biliary cirrhosis Hydroxyureab 2/25/98 Droxia To reduce the frequency of painful crises and to reduce the need for blood transfusions in adult patients with sickle cell anemia with recurrent moderate to severe painful crises 4/9/98 Sacrosidase Sucraid Oral replacement therapy of the genetically determined sucrase deficiency 6/5/98 Mafenide acetate Sulfamylon For use as an adjunctive topical solution solution antimicrobial agent to control bacterial infection when used under moist dressings over meshed autografts on excised burn wounds
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From page 327... ...
12/24/98 Modafinil Provigil Improve wakefulness in patients with excessive daytime sleepiness associated with narcolepsy 2/2/99 Alitretinoin Panretin Topical treatment of cutaneous lesions in patients with AIDS-related Kaposi's sarcoma 3/19/99 Lidocaine patch 5% Lidoderm For relief of allodynia (painful patch hypersensitivity) and chronic pain in postherpetic neuralgia 6/28/99 Doxorubicin Doxil Treatment of metastatic carcinoma liposomec,d of the ovary in patients with disease that is refractory to both paclitaxel and platinium-based chemotherapy regimens Exemestaned 10/21/99 Aromasin Treatment of advanced breast cancer in postmenopausal women whose disease has progressed following tamoxifen therapy 12/29/99 Bexarotene Targretin Treatment of cutaneous manifestations of cutaneous T-cell lymphoma in patients who are refractory to at least one prior systemic therapy Imatinib mesylated 5/10/01 Gleevec Treatment of patients with chronic myeloid leukemia (CML)
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From page 328... ...
RARE DISEASES AND ORPHAN PRODUCTS TABLE C-A1 Continued Exclusivity Indication for Original Approvala Start Date Generic Name Trade Name Topiramated 8/28/01 Topamax As adjunctive therapy in patients 2 years and older with seizures associated with Lennox-Gastaut syndrome 11/20/01 Bosentan Tracleer Treatment of pulmonary arterial hypertension 1/18/02 Nitisinone Orfadin Adjunctive therapy to dietary restriction of tyrosine and phenylalanine in treatment of hereditary tyrosinemia type 1 7/17/02 Oxybate Xyrem Treatment of cataplexy associated with narcolepsy 10/8/02 Buprenorphine in Suboxone Treatment of opioid dependence in combination with patients 16 years of age or older naloxone 10/8/02 Buprenorphine Subutex Treatment of opioid dependence in hydrochlorided patients 16 years of age or older 11/22/02 Nitazoxanide Alinia Treatment of diarrhea caused by Cryptosporidium parvum and Giardia lamblia Pegvisomantc 3/25/03 Somavert Treatment of acromegaly in patients who have had an inadequate response to surgery and/or radiation therapy and/or other medical therapies, or for whom these therapies are not appropriate Miglustatd 7/31/03 Zavesca Treatment of mild to moderate Type I Gaucher disease in adults for whom enzyme replacement therapy is not a therapeutic option 12/1/03 Somatropin Zorbtive Treatment of short bowel syndrome (r-DNA) c,e in patients receiving specialized nutritional support Cinacalcetd 3/8/04 Sensipar Treatment of hypercalcemia in patients with parathyroid carcinoma Apomorphine HClc 4/20/04 Apokyn For the acute, intermittent treatment of hypomobility, "off" episodes, associated with advanced Parkinson's disease 5/17/04 Tinidazole Tindamax (1)
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From page 329... ...
and for use as a single agent for the treatment of patients with recurrent or metastatic SCCHN for whom prior platinum-based therapy has failed Tacrolimusb,c 3/29/06 Prograf Prophylaxis of organ rejection in patients receiving allogenic heart transplants 4/28/06 Recombinant Myozyme For use in patients with Pompe disease human acid (GAA deficiency) alpha-glucosidasec,e Decitabinec 5/2/06 Dacogen For treatment of patients with myelodysplastic syndromes continued
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From page 330... ...
who have progressive, persistent, or recurrent disease on or following two systemic therapies Temsirolimusc 5/30/07 Torisel Treatment of advanced renal cell carcinoma Somatropinc,e 5/31/07 Norditropin Treatment of short stature in patients with Noonan's syndrome 6/15/07 Ambrisentan Letairis Treatment of pulmonary arterial hypertension (WHO group I) in patients with WHO class II or III symptoms to improve exercise capacity and delay clinical worsening Lanreotidec 8/30/07 Somatuline Long-term treatment of acromegalic depot patients who have had an inadequate response to or cannot be treated with surgery and/or radiotherapy 9/13/07 Raloxifene Evista Reduction in risk of invasive breast cancer in postmenopausal women with osteoporosis and reduction in risk of invasive breast cancer in postmenopausal women at high risk for invasive breast cancer Nilotinibd 10/29/07 Tasigna For the use for chronic phase (CP)
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From page 331... ...
for first orphan approval with a relevant indication. Drugs with multiple orphan designations often have exclusivity different dates associated with each approved indication.
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From page 332... ...
% Plans That Generic Name Trade Name Cover Drug Citric acid, glucono-delta-lactone, and Renacidin irrigation 0.0 magnesium carbonate Clofazimine Lamprene 0.0 Glutamine Nutrestore 0.0 Zinc acetate Galzin 0.0 Lodoxamide tromethamine Alomide ophthalmic solution 45.6 Tinidazole Tindamax 47.4 Metronidazole (topical) Metrogel 49.3 Somatropin for injection Serostim 50.4 Recombinant human acid Myozyme 51.8 alpha-glucosidase Rifampin, isoniazid, pyrazinamide Rifater 52.7 Doxorubicin liposome Doxil 53.0 Nelarabine Arranon 53.6 Cetuximab Erbitux 53.6 Somatropin (r-DNA)
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APPENDIX C % Plans That % Plans That % Plans That % Plans That % Plans That Place on Tier 3 Place on Tier 4 Have ST Have QL Have PA -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 65.2 32.8 0.0 0.5 0.0 46.4 30.7 0.0 0.3 0.0 39.5 4.6 0.0 0.0 0.1 12.5 82.9 0.0 21.1 99.6 13.5 81.8 0.0 0.0 37.8 45.8 20.2 0.0 0.0 0.0 17.4 74.3 0.0 0.0 56.7 30.8 65.0 0.0 0.0 28.1 26.0 69.6 0.0 0.0 74.6 14.0 81.8 0.0 19.8 99.5 9.3 86.0 0.0 0.0 69.5 8.4 24.2 0.0 0.0 1.1 9.2 82.1 0.0 0.0 71.7 38.5 14.3 0.0 7.1 0.0 7.9 91.7 0.0 18.2 63.2 7.3 92.2 9.8 33.4 80.4 14.2 16.0 0.0 0.0 7.4 15.6 80.9 0.0 15.4 99.7 45.9 15.3 0.0 28.2 51.9 46.2 12.3 0.0 14.7 0.0 39.1 22.7 0.0 11.5 34.5 18.4 80.9 0.0 0.0 99.8 34.7 16.3 0.0 0.0 0.0 9.4 84.6 0.0 0.0 45.9 49.3 18.7 0.0 33.9 1.3 41.0 18.1 0.0 30.7 52.1 32.0 17.0 0.0 0.0 0.0 13.8 83.5 0.0 0.3 44.7 5.0 0.0 0.0 0.0 7.9 12.8 82.0 0.1 51.9 91.1 11.6 70.5 0.0 8.6 56.5 14.8 82.0 0.0 22.7 69.8 12.4 58.5 0.0 27.6 37.9 17.7 74.5 12.0 19.7 13.6 45.6 28.7 0.0 0.0 0.0 continued
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RARE DISEASES AND ORPHAN PRODUCTS TABLE C-A2 Continued % Plans That Generic Name Trade Name Cover Drug Eltrombopag Promacta 90.5 Cysteamine Cystagon 91.9 Midodrine HCl Amatine 92.3 Modafinil Provigil 93.5 Trientine HCl Syprine 94.0 Anagrelide Agrylin 95.6 Riluzole Rilutek 95.7 Mefloquine HCl Lariam 95.8 Ambrisentan Letairis 98.3 Tiopronin Thiola 99.4 Betaine Cystadane 99.8 Pegvisomant Somavert 99.9 Tizanidine HCl Zanaflex 99.9 Cromolyn sodium 4% ophthalmic Opticrom 4% ophthalmic 99.9 solution solution Deferasirox Exjade 99.9 Ofloxacin Ocuflox ophthalmic solution 99.9 Alitretinoin Panretin 100.0 Altretamine Hexalen 100.0 Aminosalicylic acid Paser granules 100.0 Amiodarone HCl Cordarone 100.0 Bexarotene Targretin 100.0 Bosentan Tracleer 100.0 Calcium acetate Phos-lo 100.0 Cinacalcet Sensipar 100.0 Dasatinib Sprycel 100.0 Desmopressin acetate N/A 100.0 Exemestane Aromasin 100.0 Glatiramer acetate Copaxone 100.0 Hydroxyurea Droxia 100.0 Imatinib mesylate Gleevec 100.0 Infliximab Remicade 100.0 Interferon beta-1b Betaseron 100.0 Lamotrigine Lamictal 100.0 Lenalidomide Revlimid 100.0 Lidocaine patch 5 Lidoderm patch 100.0 Megestrol acetate Megace 100.0 Miglustat Zavesca 100.0 Naltrexone HCl Revia 100.0 Nilotinib Tasigna 100.0 Nitisinone Orfadin 100.0 Pilocarpine Salagen 100.0 Potassium citrate Urocit-K 100.0 Raloxifene Evista 100.0 Rifabutin Mycobutin 100.0 Rufinamide Banzel 100.0
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APPENDIX C % Plans That % Plans That % Plans That % Plans That % Plans That Place on Tier 3 Place on Tier 4 Have ST Have QL Have PA 19.3 78.0 0.0 46.0 88.7 51.0 12.0 0.0 0.0 16.1 3.5 0.0 0.0 11.5 0.2 48.8 6.9 0.2 74.3 98.5 49.2 11.5 0.0 0.0 0.0 0.1 0.0 0.0 0.1 11.5 11.5 65.9 0.0 11.1 29.1 0.0 0.0 0.0 11.2 0.2 15.5 79.8 10.8 33.6 50.7 48.2 12.5 0.0 0.0 0.0 52.0 11.0 0.0 0.0 15.0 13.7 68.9 6.3 30.2 85.9 4.3 0.0 0.0 0.1 0.1 0.0 0.0 0.0 0.9 0.2 15.3 79.3 0.0 0.0 51.2 2.1 0.0 0.0 5.3 0.2 16.2 57.6 0.0 4.2 10.8 19.3 74.6 0.0 0.0 28.6 45.5 25.6 0.0 0.0 4.4 0.0 0.0 0.0 0.0 5.1 14.0 68.0 0.0 21.5 55.2 15.0 80.0 10.6 29.8 62.4 4.3 2.2 0.0 0.0 0.2 27.9 2.2 10.5 39.8 28.6 15.2 79.7 10.7 40.9 55.4 6.3 0.0 1.4 9.3 0.1 40.4 16.9 10.7 21.1 0.0 13.0 82.4 0.0 43.8 91.7 0.0 0.0 0.0 0.0 0.2 15.2 82.3 0.0 28.8 69.0 12.6 82.5 1.1 0.0 94.4 15.3 82.4 22.6 43.0 92.1 4.2 0.0 13.8 30.6 33.5 15.0 80.2 0.0 34.6 69.9 33.6 8.4 6.3 56.4 45.7 2.1 0.0 0.0 21.3 7.4 15.9 62.4 0.0 6.7 31.1 0.0 0.0 0.0 0.0 0.2 15.2 80.0 10.7 38.7 53.2 15.6 75.3 0.0 0.0 26.4 3.1 0.0 0.0 0.0 0.2 0.0 0.0 0.0 0.0 0.2 21.1 2.2 0.0 63.8 0.0 38.5 12.4 0.0 0.0 0.0 45.7 25.6 0.0 48.3 40.9 continued
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From page 336... ...
RARE DISEASES AND ORPHAN PRODUCTS TABLE C-A2 Continued % Plans That Generic Name Trade Name Cover Drug Sacrosidase Sucraid 100.0 Selegiline HCl Eldepryl 100.0 Sodium phenylbutyrate Buphenyl 100.0 Sorafenib Nexavar 100.0 Sotalol HCl Betapace 100.0 Sulfadiazine N/A 100.0 Tacrolimus Prograf 100.0 Thalidomide Thalomid 100.0 Topiramate Topamax 100.0 Toremifene Fareston 100.0 Tranexamic acid Cyklokapron 100.0 Tretinoin Vesanoid 100.0 Ursodiol Urso 100.0 Vorinostat Zolinza 100.0 Zidovudine Retrovir 100.0
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From page 337... ...
APPENDIX C % Plans That % Plans That % Plans That % Plans That % Plans That Place on Tier 3 Place on Tier 4 Have ST Have QL Have PA 20.5 66.6 0.0 0.0 21.9 0.0 0.0 0.3 0.1 0.2 16.1 61.7 0.0 0.0 19.3 12.9 79.9 0.0 41.2 83.1 0.0 0.0 0.0 0.0 0.2 1.4 4.3 0.0 0.0 0.0 39.9 18.6 0.0 7.6 99.8 10.2 79.8 0.0 33.5 71.4 11.6 2.1 0.1 38.8 13.7 48.3 16.6 0.0 16.9 4.1 17.0 11.8 0.0 0.0 24.0 8.2 50.5 0.0 0.0 31.9 2.1 0.0 0.0 0.0 0.2 15.3 80.0 0.0 34.5 64.1 2.1 0.0 0.0 0.2 0.0
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From page 338... ...
Exclusivity Start Date Generic Name Trade Name Indication for Original Approval 10/17/85 Somatropin Nutropin For use in the long-term treatment of children who have growth failure due to a lack of adequate endogenous growth hormone secretion 10/17/85 Somatrem for Protropin For long-term treatment of children injection who have growth failure due to a lack of adequate endogenous growth hormone secretion 3/8/87 Somatropin for Humatrope For the long-term treatment of injection children who have growth failure due to inadequate secretion of normal endogenous growth hormone 8/2/90 Colfosceril Exosurf Treatment of established hyaline palmitate, cetyl neonatal for membrane disease at all gestational alcohol, tyloxapol intratracheal ages suspension 1/30/91 Succimer Chemet Treatment of lead poisoning in children capsules 7/1/91 Beractant Survanta (1) Prevention of RDS (hyaline intratracheal membrane disease)
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From page 339... ...
children at high risk of RSV disease 9/26/97 Sermorelin acetate Geref Treatment of idiopathic or organic growth hormone deficiency in children with growth failure 5/27/99 Etanercept Enbrel Reduction in signs and symptoms of moderately to severely active polyarticular-course juvenile rheumatoid arthritis in patients who have had an inadequate response to one or more disease-modifying antirheumatic drugs 9/21/99 Caffeine Cafcit Short-term treatment of apnea of prematurity in infants between 28 and less than 33 weeks gestational age 6/20/00 Somatropin Genotropin Long-term treatment of pediatric (r-DNA) patients who have growth failure due to Prader-Willi syndrome (PWS)
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From page 340... ...
for first orphan approval with a relevant indication. Drugs with multiple orphan designations often have different exclusivity dates associated with each approved indication.
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From page 341... ...
No. of % Plans % Plans Plans % Plans That That That That % Plans % Plans % Plans Cover Cover Place on Place on That That That Generic Name Trade Name Drug Drug Tier 3 Tier 4 Have ST Have QL Have PA Beractant Survanta intratracheal 0 0.0 -- -- -- -- -- suspension Botulism immune globulin Babybig 0 0.0 -- -- -- -- -- Caffeine Cafcit 0 0.0 -- -- -- -- Colfosceril palmitate, cetyl Exosurf neonatal 0 0.0 -- -- -- -- -- alcohol, tyloxapol for intratracheal suspension Histrelin acetate Supprelin injection 0 0.0 -- -- -- -- -- Ibuprofen lysine Neoprofen 0 0.0 -- -- -- -- -- Immune globulin Gamimune n 0 0.0 -- -- -- -- -- intravenous, human Mecasermin rinfabate Iplex 0 0.0 -- -- -- -- -- Respiratory syncytial virus Respigam 0 0.0 -- -- -- -- -- immune globulin (human)
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From page 342... ...
TABLE C-A4 Continued No. of % Plans % Plans Plans % Plans That That That That % Plans % Plans % Plans Cover Cover Place on Place on That That That Generic Name Trade Name Drug Drug Tier 3 Tier 4 Have ST Have QL Have PA Clofarabine Clolar 899 55.5 25.0 66.6 0.0 0.0 19.4 Mecasermin Increlex 1,347 83.1 21.4 73.1 0.0 0.0 92.0 Nafarelin acetate Synarel nasal solution 1,445 89.2 30.0 61.7 0.0 0.0 31.4 Etanercept Enbrel 1,450 89.5 11.5 83.3 1.4 45.2 93.7 Balsalazide disodium Colazal 1,536 94.8 4.4 0.0 0.0 0.0 0.2 Meloxicam Mobic 1,546 95.4 0.0 0.0 0.1 0.2 Leuprolide acetate Lupron injection 1,554 95.9 11.1 9.8 0.0 18.1 71.1 Adalimumab Humira 1,618 99.9 13.0 82.4 1.2 46.8 94.3 Felbamate Felbatol 1,620 100.0 38.1 18.9 0.0 0.0 0.0 Rasburicase Elitek 1,620 100.0 17.7 77.3 0.0 0.0 49.0 Ribavirin Rebetol 1,620 100.0 6.9 6.4 0.0 17.4 73.6
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From page 343... ...
2009b. 00 Medicare Part D National Stand-Alone Prescription Drug Plans.
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