HUB is probably working fine unfortunately. You can assume that a big factor here again is the lack on access coverage. The HUB cannot pull through scripts for patients who have no coverage or very poor coverage. Tht would equate to giving Ilumya away for free. The docs know that, the TMs know that. The true problem is gaining better coverage and making better deals. Stop making up access data that is not real or actionable.
Ilumya is dead. Just look at this step therapy from UnitedHealthcare:
Ilumya (tildrakizumab) is proven and medically necessary for provider administration for the treatment of moderate to severe plaque psoriasis when the following criteria are met:
I. Submission of medical records (e.g., chart notes, laboratory values) documenting all of the following:
A. Diagnosis of chronic moderate to severe plaque psoriasis; and
B. Greater than or equal to 5% body surface area involvement, palmoplantar, facial, genital involvement, or severe scalp psoriasis 1,2,3,6,8; and
C. Both of the following:
1. History of failure, contraindication, or intolerance to one of the following topical therapies: 4
a. Corticosteroids (e.g., betamethasone, clobetasol, desonide)
b. Vitamin D analogs (e.g., calcitriol, calcipotriene)
c. Tazarotene
d. Calcineurin inhibitors (e.g., tacrolimus, pimecrolimus)
e. Anthralin f. Coal tar; and
2. History of contraindication, intolerance, or failure of a 3 month trial of methotrexate; 6,7
and
D. History of failure, contraindication, or intolerance to both of the following preferred biologic products:
1. Humira (adalimumab)
2. Enbrel (etanercept);
and
E. One of the following:
1. History of 6 month trial of Cosentyx (secukinumab) with moderate clinical response yet residual disease
activity; or
2. Both of the following:
a. History of intolerance or adverse event to Cosentyx
b. Physician attests that in their clinical opinion the same intolerance or adverse event would not be
expected to occur with Ilumya;
and
F. Physician attestation that the patient is unable to self-administer or there is no competent caregiver to administer the drug. Physician must submit explanation; and
G. PatientisnotreceivingIlumyaincombinationwithanyofthefollowing:
1. Biologic DMARD [e.g., Humira (adalimumab), Cimzia (certolizumab), Simponi (golimumab), Cosentyx
(secukinumab), Orencia (abatacept)]
2. Janus kinase inhibitor [e.g., Xeljanz (tofacitinib)]
3. Phosphodiesterase 4 (PDE4) inhibitor [e.g. Otezla (apremilast)];
and
H. Dosing is in accordance with the United States Food and Drug Administration approved labeling; and
I. Initial authorization will be for no longer than 12 months.
