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More on Questcor (QCOR -6.4%): Aetna's (AET +0.3%) latest bulletin shows no change from its...

More on Questcor (QCOR -6.4%): Aetna's (AET +0.3%) latest bulletin shows no change from its position first taken in September on Acthar. The insurer is still limiting reimbursement of the drug only for the treatment of infantile spasms. AET asserts that the drug's other approved uses are medically unnecessary or unproven.
Comments (2)
  • Michael Fuller
    , contributor
    Comments (298) | Send Message
     
    The change was to finally include the information they alluded to back in Sept, studies. It was a document update with the info they should have included the first time, but were probably in a hurry to get it all out before the Open Enrollment period.

     

    No insurer would actually change benefit coverage or reimbursement policy in the middle of Open Enrollment when Benefit Managers have contracts on their desks. At least not without extreme circumstances like a brand new drug they recently started coverage on, now is determined to have severe adverse effects that the research studies did not find.

     

    Acthar is decades old, and the adverse effects are well documented with the FDA and in the prescribing information.

     

    Investors should not expect any insurance changes until late next spring, when insurers are having their internal meetings for 2014. Even then, with the new studies for Proteinuria during Kidney Week, it might be conservative to expect positive news on additional indications.
    30 Nov 2012, 12:46 PM Reply Like
  • pharmaman58
    , contributor
    Comments (97) | Send Message
     
    This is no news and has no impact on QCOR.

     

    Aetna has taken it upon themselves to deny coverage of an FDA-approved drug for nephrotic syndrome and multiple sclerosis relapse patients who have few other options if they fail first line corticosteroid therapy. I hope they get sued by health provider associations and by patient advocacy groups for their decision.

     

    Good thing Aetna represents only 5% of QCOR revenues, which I suspect will still be 2 or 3% when all is said and done.
    1 Dec 2012, 08:03 AM Reply Like
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