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`http://www.sfgate.com/business/article/CVS-plans-to-restrict-1-000-toena...
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`http://www.sfgate.com/business/article/CVS-plans-to-restrict-1-000-toenail-fungus-drug-6850078.php
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`CVS plans to restrict $1,000 toenail fungus drug Jublia
`By Robert Langreth Published 3:20 pm, Tuesday, February 23, 2016
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`CVS is starting a new program in April that limits the use of Valeant’s Jublia to treat toenail fungus.
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`CVS Health Corp. plans to restrict the use of a toenail fungus drug from Valeant Pharmaceuticals International Inc., as part of a plan to cut spending on
`dermatology treatments.
`
`In April, the drug benefit manager will institute a program that limits the use of Valeant’s Jublia, Chief Medical Officer Troyen Brennan said Monday. Jublia retails at about
`$1,000 for an 8-milliliter bottle, according to the website GoodRx, and patients in CVS’ program will have to try and fail to have their condition cured by other, less-expensive
`toenail fungus drugs. It’s part of a larger effort at CVS to reduce the use of costly dermatology drugs, Brennan said.
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`CVS plans to restrict $1,000 toenail fungus drug Jublia - SFGate
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`Dermatology drug costs “are out of control,” said Brennan. Last year, spending on Jublia grew 950 percent among CVS clients, Brennan said. The drug was approved by U.S.
`regulators in June 2014.
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`The program will be optional for CVS’ health insurance and employer clients. Valeant shares rose 4.4 percent Tuesday to close at $79.28. The stock has plunged since August,
`when it hit an all-time closing high of $262.52.
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`A Valeant spokeswoman didn’t immediately respond to a request for comment.
`
`Older nail-fungus medicines are “much more efficacious” than Jublia and cost far less, said Brennan. “It is a circumstance where we can go to clients and say, this is just waste
`we are eliminating.”
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`CVS’ pharmacy benefit unit manages drug plans for more than 75 million people. Brennan wouldn’t say which other drugs will be part of the new program, but said it could
`include additional Valeant drugs. Jublia will still be available in CVS’ retail pharmacies.
`
`Express Scripts
`
`Express Scripts Holding Co., CVS’ main rival, also said Monday that it had plans to make toenail fungus drugs “significantly more affordable” for its clients.
`
`“We are putting into place a specific plan for the toenail fungus products, and we are actively assessing the various challenges facing payers across the broader dermatology
`category,” David Whitrap, a spokesman for Express Scripts, said in an email. Details of Express Scripts’ plan would be available in a few weeks, he said.
`
`According to GoodRx, an online drug price comparison website, a 8-milliliter bottle of Jublia costs about $1,000, while a 4-milliliter bottle costs more than $500. By
`comparison, a 12-week supply of a generic version of Lamisil, another toe fungus drug, costs $20 or less at many drugstores, according to GoodRx.
`
`Skin drug prices rise
`
`Prices for dermatology drugs have been rising sharply, research has found. One study examined prices for 19 brand-name dermatology drugs and found an average price
`increase of 401 percent between 2009 and 2015, with most of the price increases occurring after 2011, according to results published in JAMA Dermatology this month.
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`In two clinical studies of Jublia, the drug completely cured toenail fungus problems in 15 and 18 percent of patients, according to Valeant’s Jublia website. Meanwhile, Lamisil
`tablets totally cured toenail fungus problems in 38 percent of patients in a separate study, according to the drug’s label. Jublia has minimal side effects, according to the drug’s
`website, while Lamisil has been linked to gastrointestinal symptoms, liver test abnormalities and rash, according to the drug’s label.
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`Robert Langreth is a Bloomberg writer. Email: rlangreth@bloomberg.net
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`© 2017 Hearst Communications, Inc.
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