-- Medicaid improves Phexxi coverage for more
than 3.7 million lives across 11 states --
-- Largest commercial insurer in Michigan and a marquis university plan in
Pennsylvania move Phexxi to
Preferred formulary position with $0
copay and no restrictions, affecting nearly 2.25 million lives in
aggregate --
SAN
DIEGO, Jan. 9, 2023 /PRNewswire/ -- Evofem
Biosciences, Inc. (OTCQB: EVFM) today announced multiple new
insurance wins that give millions of additional women access
to Phexxi® (lactic acid, citric acid,
potassium bitartrate) for the hormone-free prevention of
pregnancy.
"Evofem's unrelenting focus and engagement with payers continues
to deliver results, expanding and improving access to Phexxi for
millions of women across the country," said Saundra Pelletier,
Chief Executive Officer of Evofem.
Three recent Medicaid wins move Phexxi to a Preferred formulary
position with no restrictions, improving Phexxi coverage for more
than 3.7 million lives in 11 states.
- A leading Managed Medicaid provider removed the Prior
Authorization (PA) and moved Phexxi from Non-Preferred to Preferred
for 14 of its Managed Medicaid plans effective November 2, 2022. This change improved Phexxi
coverage for approximately 3 million lives in nine states:
Georgia, New York, New
Jersey, Virginia,
Maryland, Indiana, Nevada, Nebraska and Florida.
- Mississippi Medicaid removed the PA and moved Phexxi from
Non-preferred to Preferred Agent effective January 1, 2023. Mississippi has a Universal Preferred Drug
List, so this change positively impacts both Fee for Service and
Managed Medicaid beneficiaries – more than 600,000 lives.
- Phexxi was added to the Indiana State Medicaid
Preferred Drug List with no PA effective January 1, 2023. Its prior position was
Non-preferred with a PA. When Indiana transitions to
a Universal PDL on July 1, 2023,
the state's 1.4 million Managed Medicaid lives will also
gain access to Phexxi as Preferred with no PA.
Evofem also expanded its commercial coverage for Phexxi with
wins including a marquis university health plan in Pennsylvania (effective November 30, 2022) and the largest commercial
payer in Michigan (effective
January 1, 2023). These payers serve
over 2.25 million lives in aggregate. Both payers have removed the
PA and moved Phexxi to Preferred formulary status; Phexxi's new
position is $0 Preferred with no
restrictions.
Earlier in 2022, Evofem opened avenues for Phexxi with payers
including one of the nation's largest Pharmacy Benefit Managers
(PBMs); a highly respected national-level commercial payer that
added Phexxi to formulary for standard plans nationwide; large
payers in California and Hawaii, both with no copay for Phexxi
patients; and one of the largest payers in Utah, with no prior
authorization.
Under section 2713 of the Public Health Service (PHS) Act, group
health plans and health insurers are required to cover preventive
care and screenings under guidelines issued by the Health Resources
and Services Administration (HRSA). PHS Act section 2713 took
effect when added by the Affordable Care Act (ACA) in 2010. The
HRSA guidelines currently in effect were issued in 2019 and require
broad coverage of contraceptive care and services for women.
Updated guidelines issued in late 2021 took effect on January 1, 2023, for calendar year plans.
In July 2022, the Departments of
Labor, Health and Human Services, and Treasury released
further guidance regarding birth control
coverage clarifying that group health plans and insurers must
cover contraceptives at no cost to individuals. As the new guidance
reminds employers, violators of the preventive care coverage
requirements may be subject to the $100 per person per day excise tax under section
4980D of the Internal Revenue Code or a civil monetary penalty
under PHS Act section 2723. The guidance states that the
departments "will take enforcement action as warranted."
About Evofem
Evofem Biosciences, Inc., is developing
and commercializing innovative products to address unmet needs in
women's sexual and reproductive health. The Company's first
FDA-approved product, Phexxi® (lactic acid, citric acid
and potassium bitartrate), is a hormone-free, on-demand
prescription contraceptive vaginal gel. It comes in a box of 12
pre-filled applicators and is applied 0-60 minutes before each act
of sex. Learn more
at phexxi.com and evofem.com.
Phexxi® is a registered trademark of Evofem
Biosciences, Inc.
About Phexx
Phexxi is an on-demand method of birth
control used to prevent pregnancy. Phexxi is not effective when
used after sex. For more information about Phexxi, talk
to your healthcare provider and see full Product Information
at www.phexxi.com.
Forward-Looking Statements
This press release includes
"forward-looking statements," within the meaning of the safe harbor
for forward-looking statements provided by Section 21E of the
Securities Exchange Act of 1934, as amended, and the Private
Securities Litigation Reform Act of 1995 including, without
limitation, statements related to the timing and impact of the
transition by Indiana to
a Universal PDL. Various factors could cause actual results to
differ materially from those discussed or implied in the
forward-looking statements, including market and other conditions,
and you are cautioned not to place undue reliance on these
forward-looking statements, which are current only as of the date
of this press release. Each of these forward-looking statements
involves risks and uncertainties. Important factors that could
cause actual results to differ materially from those discussed or
implied in the forward-looking statements, or that could impair the
value of Evofem Biosciences' assets and business, are disclosed in
the Company's SEC filings, including its Annual Report on Form 10-K
for the year ended December 31, 2021, filed with the SEC
on March 10, 2022, its Quarterly Report on Form 10-Q for the
quarter ended September 30, 2022 filed with the SEC
on January 6, 2023 and any subsequent filings. All
forward-looking statements are expressly qualified in their
entirety by such factors. The Company does not undertake any duty
to update any forward-looking statement except as required by
law.
Contacts
Investors:
Amy Raskopf
SVP, Investor Relations
Evofem Biosciences, Inc.
araskopf@evofem.com
(917) 673-5775
Media:
media@evofem.com
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SOURCE Evofem Biosciences, Inc.