This may be a bad break for drugmakers. Wellpoint is using comparative effectiveness to make it more difficult for its members to use the Boniva osteoporosis drug after its own research found greater fractures, lower compliance and higher costs than other meds, according toDow Jones.
The insurer studied 26,000 members on osteo meds, comparing Boniva, which is marketed by Roche and GlaxoSmithKline with Actonel, which is sold by Sanofi-Aventis and Warner Chilcott, and Merck's Fosamax. Although randomized clinical trials suggest the drugs should be equivalent, WellPoint data found differences. Now, WellPoint other drugs must be tried before Boniva is approved.
The drug remains where on Tier 3, or non-preferred level, on the formulary. WellPoint actually made the change last year, Dow Jones writes, although last month, WellPoint announced it had developed standardized comparative effectiveness guidelines to evaluate a drug's ability to improve outcomes. Another approach is taken by RegenceRx, the not-for-profit arm of the Regence Group that includes several BlueCrossBlueShield insurers, by analyzing the quality of clinical trials promulated by pharma (see this).
Three months ago, by the way, the FDA determined there is no link between these drugs and thigh-bone fractures, even though a warning had been issued two years ago (background here). Nonetheless, the agency is continuing to work with outside experts to analyze more info.