Optum, a pharmacy benefit manager owned by one of the country’s largest insurance companies, UnitedHealth Group, has added a new, much-anticipated pain drug to some of its commercial formularies.

奥普特姆（Optum）是一家由美国最大的保险公司之一联合健康集团（UnitedHealth Group）拥有的药房福利管理公司，已将一种新的、备受期待的止痛药添加到其部分商业处方集中。

Sold as Journavx, the drug received

作为Journavx销售的药物获得

U.S. approval in late January

美国在1月底批准

as a treatment for the short-lived “acute” pain typically felt after an operation or accident. Journavx works differently than other available medications, and its developer, the biotechnology juggernaut Vertex Pharmaceuticals, has positioned it as an important, non-opioid option for pain management..

作为一种治疗手术或事故后通常会感受到的短暂“急性”疼痛的方法。Journavx 的作用机制不同于其他现有药物，其开发商生物技术巨头 Vertex Pharmaceuticals 将其定位为疼痛管理领域中一种重要的非阿片类替代方案。

While doctors have welcomed this additional tool, and some analysts see it as a multibillion-dollar product,

虽然医生们对这一额外工具表示欢迎，且一些分析师认为这是一个价值数十亿美元的产品，

substantial commercial barriers

实质性的商业壁垒

could constrain patient access as well as sales. Cheap opioids have long dominated the pain drug market. At a list price of $31 a day, Journavx is many times more expensive than generic versions of drugs like hydrocodone.

Ahead of the drug’s approval, Stuart Arbuckle, Vertex’s chief operations officer, said price and access were the biggest issues stakeholders had raised in discussions on Journavx. Still, he said then that conversations with insurers were going well.

在该药物获批之前，福泰制药首席运营官斯图尔特·阿布克尔表示，在就Journavx进行的讨论中，利益相关者提出的最大问题在于价格和获取途径。不过，他当时表示，与保险公司的对话进展顺利。

“We’re encouraged Optum has added Journavx to its formulary, reflecting the unmet need for new treatment options and the promise of Journavx in acute pain, and we continue to work with them and other payers to ensure broad availability,” Heather Nichols, a Vertex spokesperson, said in a statement.

“我们很高兴Optum将Journavx纳入其处方集，这反映了对新治疗方案的未满足需求以及Journavx在急性疼痛治疗中的潜力，我们将继续与他们及其他支付方合作，确保广泛的可用性，”Vertex发言人希瑟·尼科尔斯在一份声明中表示。

Optum’s move,

奥普特姆的举措，

first initially reported by Bloomberg

首次由彭博社报道

, appears to be the first significant, public update about Journavx coverage from a major commercial payer. Other healthcare giants, including CVS, Humana and Cigna, either declined or didn’t immediately respond to requests for updates on their coverage plans.

，似乎是主要商业支付方对Journavx覆盖范围的首次重大公开更新。其他医疗保健巨头，包括CVS、Humana和Cigna，要么拒绝了，要么没有立即回应对其覆盖计划更新的请求。

The team that crafts the list of prescription drugs that Optum covers is still evaluating the clinical data underpinning Journavx “and will make a recommendation on formulary placement soon,” according to Elizabeth Hoff, a spokesperson for Optum’s pharmacy care services division.

根据Optum药房服务部门发言人伊丽莎白·霍夫的说法，“负责制定Optum覆盖的处方药清单的团队仍在评估支持Journavx的临床数据，并将很快对药品目录的定位提出建议。”

“In the interim, Journavx was added to our standard commercial formularies to allow immediate access to a non-opioid option for moderate-to-severe pain in the acute setting,” Hoff added.

“在此期间，Journavx被加入我们的标准商业处方集，以便在急性环境中立即获得用于中度至重度疼痛的非阿片类选项，”霍夫补充道。

Optum has, for now, put Journavx on “Tier 3” of its formulary, which is designated for “higher-cost brand name” drugs along with some generics. Optum notes that using lower tier or “preferred medications” can help lower out-of-pocket costs for patients.

Optum目前将其Journavx置于“第三层”处方集中，该层是为“高成本品牌药”以及一些仿制药指定的。Optum指出，使用较低层级或“首选药物”可以帮助患者降低自付费用。

Not long before Journavx’s approval, analysts at the investment firm Cantor Fitzgerald said they spoke to a senior director of product development at UnitedHealth Group. According to analyst Olivia Brayer, the director expected Journavx to receive broad coverage because insurers are under pressure to cover non-opioid pain medications..

就在Journavx获批前不久，投资公司Cantor Fitzgerald的分析师表示，他们与联合健康集团的产品开发高级主管进行了交谈。据分析师奥利维亚·布雷尔称，该主管预计Journavx将获得广泛覆盖，因为保险公司面临覆盖非阿片类止痛药的压力。

He also did not anticipate Journavx having to go through “step therapy,” a controversial practice in which patients must “fail” on cheaper drugs before an insurer agrees to cover newer, pricier medicines.

他也没有预料到 Journavx 将不得不经历“阶梯疗法”，这是一种备受争议的做法，患者必须先在较便宜的药物上“失败”，保险公司才会同意覆盖更新、更昂贵的药物。

In a note to clients, Leerink Partners analyst David Risinger described UnitedHealth's initial coverage as 'encouraging.'

在给客户的一份报告中，Leerink Partners 分析师大卫·莱辛格将联合健康集团的初步覆盖范围描述为“令人鼓舞”。

'Bottom line: We are pleased to see a major PBM cover Journavx ahead of its launch for acute pain,' Risinger wrote.

“底线是：我们很高兴看到一家主要的药品福利管理公司（PBM）在Journavx上市前就覆盖了其用于急性疼痛的治疗，”Risinger写道。

Medicaid plans in two states —

两个州的医疗补助计划——

New York

纽约

and

和

Arkansas

阿肯色州

— have also put policies in place for Journavx.

—— 也为 Journavx 制定了相关政策。