CivicaScript is a sister company to Civica Rx, which a group of health systems launched six years ago to address generic drug shortages at hospitals.
CivicaScript, founded in 2020, focuses on the outpatient drug market, with an emphasis on transparency.
A third entity, Civica Foundation, supports their work through fundraising.
“Because we’re not for profit, we can look at the supply chain in a very different way, and we’re always going to do what’s in the best interest of patients,” said Eberle, who joined CivicaScript as president at the end of September.
Navitus is a pharmacy benefit manager, which operates as a middleman between drug companies, payers and pharmacies in the drug supply chain. It’s one of the founding members of CivicaScript, as is Elevance Health, which operates Anthem Blue Cross and Blue Shield of Wisconsin.
“I started at the very beginning at Navitus 20 years ago and was kind of on the ground floor of a transparent-and-passthrough PBM,” Eberle said in a recent interview. “About 10 years ago, we did the same thing with starting a transparent-and-passthrough pharmacy. And so the opportunity to help develop a transparent-and-passthrough manufacturer was, to me, just a cool opportunity to connect three key points in the drug supply chain.”
CivicaScript is offering one product, abiraterone acetate, a prostate cancer medication. It’s planning four more specialty generic drug launches during the first half of 2025. Alongside Civica Rx, it’s working to bring affordable insulin to the market.
Edited excerpts from Eberle’s interview with Wisconsin Health News are below.
WHN: How is CivicaScript lowering prices?
Eberle: One of the main things that CivicaScript has done is create what we call our max retail price, or MaxRP, concept. It establishes the price of the product all the way to the end. We put a QR code on our products, such that when a patient gets a dispensing of a CivicaScript product, they can use that QR code to see exactly what the cost was. That’s really the max retail price. We ship our product to any pharmacy that is willing to participate, and then in participating, they’re agreeing to the MaxRP process. We work with our insurance plans, through the health plans and the PBMs, to make sure that that price gets adjudicated as well. So it’s a combination of working with the payers, the pharmacies and the patient, and then really ensuring that the patient will never pay more than that max retail price at the end of the day.
CivicaScript is looking at generic products, typically generic products that have a high spread or a large variability in price. Our first product, abiraterone, 250 milligram tablets, is the generic for Zytiga, the prostate cancer medication, and was a really good target. We were seeing prices averaging around $3,000. Our product is $160, plus an $11 pharmacy dispensing fee, for a max retail price of $171.
WHN: What has been the ramp up process since CivicaScript’s launch?
Eberle: On the Civica Rx side, they have 80 products. On the CivicaScript side, we have one. Currently, we are launching four more in the first half of 2025.
One of the things I just want to go back to, in terms of the uniqueness of the model, and this holds true for both organizations, is it’s the same price for everyone. It’s not one price for this payer, one price for that payer, one price on Tuesday, a different price at a different pharmacy. It’s one price, regardless of pharmacy, line of business, all of those things. That price is public, and that’s the same price that everyone gets. We feel that that’s important from providing that predictability to both patients and payers, so that they know exactly what the costs are.
For us, in the first couple of years, the process was pretty unique in terms of, ‘How do we connect patients with products?’ It’s taken some time to figure out the mechanics of doing that. Our founding members represent about 100 million covered lives across the country. They work with all the different PBMs, so we had to work with each of them to figure out how to best administer the program. Now that we’re off and running with our first product, we’re excited to see what we can do with the next round of products.
WHN: What’s entailed with your insulin affordability project?
Eberle: It’s a great example of all three of the Civica companies working together. The Civica Foundation was really charged with helping do the funding for the research. Civica Rx is going to be doing the manufacturing. We have a facility in Petersburg, Va. that is a state-of-the-art sterile injectable facility that’s in the process of coming online now. Out of that facility, we’ll be making a number of sterile injectables that the Civica Rx products and hospitals will use, but also we’ll be making our biosimilar insulin out of that facility. We are going to be launching all three of the most common forms of insulin, and the pricing for each will be $30 vials and $55 for the pens. We are working through that process with getting the plant online and getting (Food and Drug Administration) approval for the biosimilar versions of the insulins.
CivicaScript’s role is helping connect the patients to the product. We will be working with the health plans around formulary decision-making and with the pharmacies and wholesalers around distribution.
WHN: What’s next?
Eberle: We have four more products coming in the first half of next year. We hope to have that portfolio up to 20 products in the next two to three years. And we’re really starting to focus also on the biosimilar market. We think there’s a real opportunity to add transparency to that set of products, particularly looking at biosimilars for Stelara and Humira. If you’ve followed that pricing at all, it’s been all over the place, and some of that is due to the overall lack of transparency when it comes to biosimilars. We think that that’s a real opportunity for the organization.
And then obviously getting ready for the insulin launch will be another huge initiative. We think that there is definitely a need in this space, even after some of the price adjustments that have happened, because we want to make sure that we can be a safety net and have the product available if other manufacturers choose not to continue to operate in that space. We want to be able to provide that predictability of supply and assurances to the people that need those medications that the product is going to be there.
There is a really bright future, which is why I’m so excited to be here. It’s a tremendous group of very dedicated people that are trying to really make fundamental changes to the overall drug supply chain, and doing it all for the right reasons, which makes it a lot of fun.
This article first appeared in the Wisconsin Health News daily email newsletter. Sign up for your free trial here.