Tuesday, April 30, 2024

Stick, Twist Or Split? Generics Industry's Big Three Place Their Bets

(4/29, David Wallace, Generics Bulletin) ...With Teva and Viatris recently under new management and Sandoz having last year split from former parent company Novartis, the three off-patent industry leaders are adopting different strategies for how they balance their generics and biosimilars interests with more innovative ventures...Teva is focusing investments on its innovative business as part of its new ‘Pivot To Growth' strategy, while at the same time maintaining a significant generics and biosimilars business... Global Sub. Full

Alvotech, Teva to Manufacture Biosimilar to Humira for Quallent

(4/30, The Fly) ...Alvotech and Teva Pharmaceuticals, a U.S. affiliate of Teva Pharmaceutical, disclosed that under the recently announced U.S. strategic partnership agreement, Alvotech will manufacture its high-concentration interchangeable biosimilar to Humira for Quallent Pharmaceuticals, in alignment with its U.S. commercialization agreement with Teva...Alvotech handles development and manufacturing, and Teva is responsible for U.S. commercialization, which leverages Teva's experience and sales and marketing infrastructure... Full

Alvotech To Manufacture Its High-Concentration Interchangeable Biosimilar To Humira For Quallent

(4/30, RTT News) ...Alvotech and Teva Pharmaceuticals, a U.S. affiliate of Teva Pharmaceutical Industries, said, under the recently announced U.S. strategic partnership agreement, Alvotech will manufacture its high-concentration interchangeable biosimilar to Humira for Quallent Pharmaceuticals with, in alignment with its U.S. commercialization agreement with Teva... Full

Pfizer to Pay $25.5 Mln to Settle Remaining Effexor XR Antitrust Claims

(4/29, Brendan Pierson, Reuters) ...Pfizer has agreed to pay $25.5 million to resolve claims that its predecessor Wyeth conspired with rival Teva to delay launching a less expensive generic version of antidepressant Effexor XR, in addition to a $39 million settlement disclosed earlier this month... Full

Pfizer Settles Remaining Effexor XR Antitrust Claims for $25.5 Million

(4/29, CPI) ...Pending judicial approval, these settlements would bring an end to over 12 years of legal battles revolving around allegations that Wyeth's collaboration with Teva violated U.S. antitrust laws. Notably, Teva remains excluded from the settlement agreements, indicating that legal proceedings against the company will persist... Full

Competition From Skinny-Label Generics Saved Medicare Nearly $15B Over 5 Years

(4/29, Laura Joszt, MA, AJMC) ...Skinny labels, which carve out patent-protected indications from generics, have generated nearly $15 billion in Medicare savings from 2015 to 2020, and a new court decision could deter the use of skinny labeling, explained a letter published in Annals of Internal Medicine...GlaxoSmithKline sued Teva for its marketing of carvedilol (Coreg), a ß-blocker. The argument was that Teva was inducing physicians to prescribe the drug for carved out indications still under patent protection, thus infringing on the patents.3 The US Supreme Court declined to hear Teva's challenge to the $235 million award it owed GSK... Full

'Skinny Label' Generics Saved Medicare $14.6B

(4/29, John Commins, HealthLeaders) ...A federal appeals court in 2021 upheld the award and rejected Teva's claim that it had followed Food and Drug Administration mandates to "carve out" a patented use for the drug to treat heart failure. The appeals court affirmed GSK's complaint that Teva's labeling and marketing encouraged physicians to prescribe the generic for patent-protected conditions. "This court's decision may discourage the marketing of skinny label generics," the brief notes... Full

Decision to Award Principal Supply Status for Dasatinib Tablets

(4/30, Pharmac) ...As part of our Annual Invitation to Tender process, a decision has been made to award Principal Supply Status of dasatinib tablets to Dasatinib-Teva, supplied by Teva Pharma (New Zealand) Limited (Teva). This means that there will be a be a change in the funded brand of dasatinib. Dasatinib-Teva will be listed on the Pharmaceutical Schedule from October 1, 2024 and it will be the principal funded brand of dasatinib from March 1, 2025 until June 30, 2027... Full

These Are the Drugs America Is Running Short On

(4/29, Aaron Webber, 24/7 Wall St) ...Although specific statistics do not exist that show which drugs are impacting the largest amounts of patients, here is a list that can give an idea of just how widespread this issue is affecting the medical community...Amphetamine Extended-Release Oral Presentations...Sandoz has discontinued production, Sun Pharma has discontinued production, and Teva did not provide a reason for its shortage...Testosterone 2% Topical Gel...Reason for Shortage: Par has discontinued its manufacturing of the drug, leaving only Teva and Endo as the remaining manufacturers... Full

Hikma Strikes AG Nucynta Agreement As Clock Ticks On Opioid's IP Life

(4/29, Dean Rudge, Generics Bulletin) ...Hikma will look to guarantee US generic competition to the powerful opioid brand Nucynta, albeit in the form of an authorized generic, as questions swirl over the appetite of at least one ANDA filer to compete on an equal footing, per the terms of a patent-litigation settlement deal...Nucynta ER has Orange Book-listed IP that extends into 2028, although competition is expected earlier. "Teva is one of two companies that settled on Nucynta ER [for market entry] in 2026. But based on our conversations with Collegium's management, tapentadol active pharmaceutical ingredient is not readily available, must be made in the US, and takes two or three years for a drug master file to scale the drug, which we would expect should be ongoing if the company planned on launching in 2026," Jefferies explained in a late March note... Global Sub. Full

Sandoz Settlement Sets Date For US Denosumab Entry

(4/30, David Wallace, Generics Bulletin) ...After kicking off March with the announcement of US Food and Drug Administration approval for two denosumab biosimilars, Sandoz has closed out April by revealing that it has secured a launch date of May 31, 2025 for the products through a litigation settlement with originator Amgen...Teva has a denosumab biosimilar in Phase III trials and Fresenius Kabi is also targeting future denosumab filings, while Samsung Bioepis late last year reported positive Phase I and Phase III trial results for its SB16 proposed denosumab biosimilar... Global Sub. Full

Amgen, Sandoz Settle Clash Over Biosimilars of Blockbuster Drugs

(4/29, Christopher Yasiejko, Bloomberg Law) ...Amgen Inc. and Sandoz Group AG settled a patent-infringement lawsuit over biosimilar versions of Amgen's Prolia and Xgeva bone-strengthening treatments, according to a New Jersey federal judge's order. The agreement means Sandoz is prohibited from selling the competing treatments until Feb. 19, 2025, according to Judge Christine P. O'Hearn's order. The decision also disclosed that, as part of the settlement's binding term sheet, Sandoz conceded to infringement of US Patent No. 7,364,736, prohibiting the sale of their biosimilars, Jubbonti and Wyost... Sub. Req'd

Sunshine Subsidiary Nora Pharma Secures Canadian Approval For Neulasta Biosimilar

(4/29, Adam Zamecnik, Generics Bulletin) ...Sunshine Biopharma's generics focused subsidiary Nora Pharma has received approval for its biosimilar to Amgen's Neulasta (pegfilgrastim) from Health Canada. Marketed under the name Niopeg, the injectable drug is the first biosimilar produced by Sunshine's subsidiary. It comes in pre-filled syringes of 6mg/0.6ml... Global Sub. Full

Cigna Move Offers More Good News For US Humira Biosimilars

(4/29, David Wallace, Generics Bulletin) ...Cigna's Evernorth has announced plans to make a Humira biosimilar available for $0 out-of-pocket for Accredo patients from June, adding to momentum for adalimumab rivals from previous policy changes made by CVS in recent weeks. Meanwhile, AbbVie has offered the latest on how competition to its once top-selling brand is ramping up...The only high-concentration 100mg/ml adalimumab biosimilar approved by the US Food and Drug Administration so far is the Teva-Alvotech partnered Simlandi (adalimumab-ryvk) version that was approved in February 2024 but has not yet launched... Global Sub. Full

Lead Drug from J&J and Addex's 20-Year Collaboration Flunks Phase 2 in Epilepsy

(4/29, Amber Tong, Endpoints News) ...The candidate, ADX71149, did not make a statistically significant difference in time to baseline seizure count when added to the standard of care. Addex is still analyzing the data and will work with its partner, J&J, to determine the next steps for the program, Chief Medical Officer Roger Mills said in a statement... Full

AstraZeneca, Daiichi Tout Enhertu Trial Win in Earlier, Broader HER2-Low Breast Cancer

(4/29, Angus Liu, Fierce Pharma) ...After spearheading the new HER2-low category in breast cancer treatment, Enhertu has shown it could be useful against HR-positive metastatic breast cancer with even lower expression of the HER2 protein. Enhertu significantly outperformed standard chemotherapy at extending the time before tumor progression or death among patients with HR-positive, HER2-low metastatic breast cancer who had tried at least one prior line of endocrine therapy, AZ and Daiichi said Monday. The phase 3 DESTINY-Breast06 trial has therefore met its primary endpoint... Full

Granules India Gets ANDA Approval for Colchicine Capsules

(4/30, Express Pharma) ...Granules India has received approval from the US Food & Drug Administration for its Abbreviated New Drug Application, filed by Granules Pharmaceuticals, a wholly owned foreign subsidiary of the Company, for Colchicine Capsules, 0.6 mg. It is bioequivalent and therapeutically equivalent to the reference listed drug, Mitigare Capsules, 0.6 mg of Hikma International Pharmaceuticals... Full

AstraZeneca's Farxiga Authorized Generic Aims To Broaden Access As Medicare Price Cut Looms

(4/29, Cathy Kelly, Pink Sheet) ...AstraZeneca launched a Farxiga authorized generic in January that aims to capture additional market share. The move could help recoup the cost of developing additional indications in kidney disease and heart failure before Farxiga is subject to price negotiation in Medicare Part D in 2026. An authorized generic also could ameliorate the negative financial impact of the January elimination of the Medicaid AMP cap... Sub. Req'd

Edelweiss Fund to Back Matrix Lab Founder's Buyout of Viatris API Biz

(4/30, Shilpy Sinha and Viswanath Pilla, The Economic Times) ...A fund managed by Edelweiss Alternatives has committed 200 crore to a debt facility being arranged by Kotak Strategic Situations Fund to finance Matrix Laboratories founder Nimmagadda Prasad's acquisition of the active pharmaceutical ingredients business of American pharma firm Viatris... Full

One Dose of Novo Nordisk's Wegovy Back in Supply, FDA Website Shows

(4/29, Sriparna Roy and Pratik Jain, Reuters) ...The U.S. Food and Drug Administration's website showed on Monday one dose of Novo Nordisk's weight-loss drug Wegovy as available after being in short supply, while three other doses remained in limited availability due to increased demand..."We are aware that another manufacturer has communicated supply shortages for its obesity medicine, which may have implications for Wegovy demand," the Danish drugmaker told Reuters in an emailed response. "We are actively producing and shipping all dose strengths of Wegovy into the U.S. market," the company said... Full

Drug Shortage Management Becomes New Normal for Pittsburgh-Area Hospital Pharmacists

(4/29, Jessica Guay, CBS News) ...Staying ahead of drug shortages is a constant battle for hospital pharmacists. "We definitely feel that. Every year, there are more drug shortages to worry about," said Rebecca Taylor, vice president of UPMC pharmacy services. New American Society of Health-System Pharmacists data shows 323 medications are in short supply across the country, the highest since tracking started in 2001. "It primarily affects us in the drugs that are available as generics and the drugs that are available as IV. So, we do spend a considerable amount of time managing and changing and fixing things in our electronic system to help the doctors go to the drugs that we do have and shift them away from the drugs that we don't have," Taylor said... Full

Expert Discusses Cost Savings Through Biosimilars

(4/29, Pharmacy Times) ...Tasmina Hydery, PharmD, BCGP, discusses how stakeholders can maximize cost savings from biosimilars through collaboration. She notes biosimilars' growth in immunology and oncology, where they provide opportunities to leverage the competitive landscape... Full

Payer Coverage of Biosimilars Always Shifting, Says Dr Tasmina Hydery

(4/29, Laura Joszt, MA and Ashley Gallagher, AJMC) ...Payers are covering multiple biosimilars of reference products and always reevaluating those coverage choices, explained Tasmina Hydery, PharmD, MBA, BCGP, associate director in digital solutions, Cencora. The decisions of payers might have a stronger sway in uptake of certain biosimilars than being first to market or even having interchangeability, although this could change as more interchangeable biosimilars come to market...Hydery will discuss the latest updates on biosimilars and their coverage and adoption in the US during a session at the Asembia Specialty Pharmacy Summit, being held April 28 to May 3 in Las Vegas, Nevada... Full

For Drugs, the Launches Are Getting Harder, Longer | Asembia 2024

(4/29, Peter Wehrwein, Managed Healthcare Executive) ...Newly launched drugs coming are facing payer controls and other hurdles, says Luke Greenwalt, vice president, market access, at IQVIA. In an interview conducted before his presentation at Asembia 2024 meeting on April 29, Luke Greenwalt, M.D., vice president, market access, of IQVIA, discussed trends in drug launches... Full

J&J, Bristol Myers Lose Challenges to US Drug Price Negotiation Program

(4/29, Brendan Pierson, Reuters) ...A U.S. judge on Monday rejected a challenge by Bristol Myers Squibb and Johnson & Johnson to a law requiring them to negotiate the prices of their blockbuster blood clot prevention drugs with the U.S government's Medicare health insurance program or pay heavy penalties... Full

J&J, Bristol Myers Squibb Lose Biden Drug Price Plan Lawsuits

(4/29, Nyah Phengsitthy, Bloomberg Law) ...The manufacturers' claims that the Medicare Drug Price Negotiation Program violates the First Amendment compelled speech doctrine and Fifth Amendment takings clause were tossed by Judge Zahid N. Quraishi of the US District Court for the District of New Jersey. The drugmakers argued that the program forces them to sign a contract and agree to a maximum fair price ultimately set by Medicare, and that the pricing scheme is a taking backed by a tax penalty. Johnson & Johnson's Xarelto and Bristol Myers Squibb's Eliquis were among the 10 drugs selected for the first negotiation round... Sub. Req'd

Federal Judge Throws Out Two Drugmaker IRA Lawsuits in Win for Government

(4/29, Nicole DeFeudis, Endpoints News) ...In a summary judgment, Judge Zahid Quraishi ruled the IRA provisions don't constitute a physical taking of property or a violation of speech, the two constitutional claims at the core of the drugmakers' arguments. The opinion could impact similar cases playing out in other courts across the country...Bristol Myers has already filed to appeal the decision in the Third Circuit... Full

Federal Judge Rules Against Two Drugmakers Challenging Medicare Drug Price Negotiation Program

(4/29, Rachel Cohrs Zhang, STAT Plus) ...The loss is a setback for the pharmaceutical industry's strategy of getting split decisions in lower courts across the country to eventually get the attention of the Supreme Court...Drugmakers argued that the Medicare program is so large that it would have been financially ruinous for them to leave the program... Sub. Req'd

AstraZeneca Takes Drug-Price Negotiation Suit to Third Circuit

(4/29, Nyah Phengsitthy, Bloomberg Law) ...The diabetes drugmaker on Monday filed notice for its appeal to the US Court of Appeals for the Third Circuit after the dismissal of its case against the Medicare Drug Price Negotiation Program...AstraZeneca's approach to striking down the Biden administration's pricing scheme rested on claims that the program's implementation violates the Administrative Procedure Act and the Fifth Amendment due process clause... Sub. Req'd

PhRMA to Revive Medicare Drug Price Lawsuit Before Fifth Circuit

(4/30, Nyah Phengsitthy, Bloomberg Law) ...Attorneys for the National Infusion Center Association, the Global Colon Cancer Association, and the Pharmaceutical Research and Manufacturers of America will take to the US Court of Appeals for the Fifth Circuit to argue their case against the Biden administration's Medicare Drug Price Negotiation Program. At issue is whether the groups' claims arise under a certain Medicare statute and if they have Article 3 standing to challenge the program's constitutionality... Full

Patient Access and Insulin: Market Forces, Innovative PBM Programs Lowering Costs for Patients

(4/29, PCMA) ...Annual list price increases on insulins have, for the most part, stopped, while net prices – paid by employers and health plans – continue to fall. That means lower insulin costs for patients as evidenced by a recent IQVIA report found that "Across all patients, benefit design changes combined with the availability of biosimilars are contributing to falling insulin costs." More biosimilars coming to market allows PBMs to more effectively leverage competition to reduce drug costs for health plan sponsors and patients... Full

Researchers: IRA May Disrupt Development Of Non-Opioid Pain Meds

(4/29, Gabrielle Wanneh, InsideHealthPolicy) ...A controversial provision under Medicare's new drug price negotiation program that permits Medicare to negotiate lower prices for small-molecule drugs after nine years on the market could throw off existing efforts to curb an ongoing epidemic of opioid overdoses in the United States by disincentivizing the development of non-opioid pain medications, most of which are small molecule drugs, according to a new policy paper by the Pioneer Institute... Sub. Req'd

Drug Channels News Roundup, April 2024: CVS's Humira Strategy, White Bagging "Savings," IRA vs. Part D Plans, Walgreens Specialty Update, Pharmacies vs. GoodRx, and Oncology Fun

(4/30, Adam J. Fein, Ph.D., Drug Channels) ...As I described in January's review of PBMs' 2024 formularies, CVS Caremark began excluding Humira from most (but not all) of its major commercial formularies on April 1. Its 2024 Advanced Control Specialty Formulary now contains three preferred options: Hyrimoz, the high-list-price Humira biosimilar from Sandoz; Hyrimoz, the low-list-price Humira biosimilar from Cordavis; and adalimumab-adaz, the unbranded, low-list-price Humira biosimilar from Sandoz. And guess what? This approach drove a noticeable jump in Hyrimoz prescriptions in the first three weeks of April... Full

Former Trump Official Talks IRA Tweaks, Drug Shortages, Reference Pricing, March-In

(4/29, Maaisha Osman, InsideHealthPolicy) ...Joseph Grogan, who headed the Domestic Policy Council for the former Trump administration, tells Inside Health Policy it would be legislatively difficult to revise the Inflation Reduction Act due to Congressional Budget Office scoring, but he thinks there are several steps Donald Trump if reelected could take to make Medicare drug negotiations more transparent...A White House spokesperson told IHP that the Biden administration will expand Medicare negotiations under the IRA to lower drug prices rather than adopting policies like most favored nation pricing favored by Trump and Sanders... Sub. Req'd

The IRA One Year Later | Asembia 2024

(4/29, Peter Wehrwein and Denise Myshko, Managed Healthcare Executive) ...Cencora's Corey Ford says after the IRA's out-of-pocket cap goes into effect next year, Part D plans are expected to put in place more narrow drug coverage and pharma companies will likely face a more competitive environment. There could be some unintended consequences from the Medicare's cap on beneficiary out-of-pocket costs, according to Corey Ford, vice president of reimbursement and policy insights at Cencora... Full

Senate Hearing Likely To Discuss Chinese Pharmaceutical Security

(4/29, Jessica Karins, InsideHealthPolicy) ...The Senate Committee on Armed Services will hear testimony Tuesday (April 30) on Department of Defense initiatives to ensure pharmaceutical safety, in a hearing that is likely to touch on issues of generic drug quality and American dependence on pharmaceuticals manufactured in China... Sub. Req'd

California Cuts Overdose-Reversal Costs With $24 Nose Spray

(4/29, Nadia Lopez, Bloomberg) ...California is stepping up efforts to combat surging opioid-related deaths by teaming with a maker of generic pharmaceuticals to bolster the supply of naloxone, a drug that can reverse overdoses. Under the deal with Amneal Pharmaceuticals, the state will buy twin packs of naloxone nose spray for $24, or about 40% less than what it currently pays for a similar product, Governor Gavin Newsom said in a statement Monday. The lower price will enable California to get the drug into more hands, he said... Full

California is Joining with a New Jersey Company to Make a Generic Opioid Overdose Reversal Drug

(4/29, Adam Beam, Associated Press) ...The New Jersey-based Amneal Pharmaceuticals will sell naloxone to California for $24 per pack, or about 40% cheaper than the market rate. California plans to give away many of the packs for free to first responders, universities and community organizations through the state's Naloxone Distribution Project. But it will also sell some of the packs at the discounted rate to California businesses and local governments — as long as they agree not to mark up the prices and sell it for a profit. The goal is to expand the distribution beyond schools and public health departments and into places including restaurants, entertainment centers and ride-hailing services such as Uber and Lyft... Full

A Colorado Board Wants to Lower Prescription Drug Costs. Why Are So Many Patients Opposed?

(4/30, John Ingold, The Colorado Sun) ...The most recent edition of the Colorado Health Institute's Colorado Health Access Survey found that nearly 11% of people in 2023 did not fill a prescription because of cost. That number has remained more or less unchanged since the survey began in 2009. "The original goal of the PDAB is to increase access to drugs," said Hope Stonner, a policy coordinator at the Colorado Consumer Health Initiative, which supports the PDAB. "Folks aren't taking drugs because of cost."... Full

Oh, Canada: U.S. Patients Don't Want Your Health Policies

(4/29, Sally Pipes, Forbes) ...The Canadian government has chosen to deprive its citizens of the latest therapies by dictating the prices drug makers must abide by if they want access to the Canadian market. And now, the Biden administration and several states are looking to deploy Canadian-style tactics here at home. When public officials levy price controls on prescription drugs, they're putting the government's finances ahead of patients' lives... Full

MHRA Needs ‘Rebuilding' After Post-Brexit Loss Of Capacity & Industry Investment

(4/29, Eliza Slawther, Pink Sheet) ...While government funding cannot solve many of the challenges faced by the pharmaceutical industry in the UK, the country's drugs regulator does need more funding to rebuild itself in a post-Brexit context, according to venture capitalist Dame Kate Bingham...Bingham said that the UK's medical research environment had "huge industry support," and that AstraZeneca was the "biggest funder of R&D in the country across all sectors." "That is what we need to nurture. So if I have a message to the government, it is ‘be nice to industry, don't assume they're always going to nick your wallet when you come into the room,' because that is the instinctive view," she declared... Sub. Req'd

EU & South Korea Sign Deal On Exchange Of Confidential Information

(4/29, Ian Schofield, Pink Sheet) ...The EU and South Korea have agreed a new partnership under which they will be able to exchange confidential information on medicines in areas such as quality, safety and efficacy, as well as clinical trial approvals, adverse reaction data, and inspections. The confidentiality arrangement, which took effect on April 25, will allow the sharing of "certain specific scientific and technical information and documents" relating to human-use medicines that are either authorized for marketing or are under review in either of the jurisdictions, the parties said... Sub. Req'd

Long Road Ahead for EU Pharma Package Says Polish Pharmaceutical Sector

(4/29, Paulina Mozolewska, Euractiv) ...Poland's pharmaceutical industry says there's still a long journey ahead for the revision of the EU's pharmaceutical legislation. Despite the Pharma Package now heading to Council, the Polish Ministry of Health chooses to remain silent..."Despite the amendments introduced in the European Parliament, the pharmaceutical legislation still has a long journey ahead to restore Europe's competitive edge," Michal Byliniak, Director-General of The Employers' Union of Innovative Pharmaceutical Companies INFARMA, told Euractiv... Full

Record US Drug Shortage a Positive for Indian Pharma Companies

(4/30, Neetu Chandra Sharma, Business Today) ...Analysts Rahul Jeewani and Naman Bagrecha at IIFL Securities in a report said that the drug shortage, unseen since its peak in the third quarter of 2014, presents an opportune time for these enterprises. The number of drugs under short supply rocketed from 271 in the first quarter of 2021 to 323 in the same quarter of 2024--the highest tally since the American Society of Health-System Pharmacists began keeping a record in 2001... Full

Indian Pharmaceutical Industry Set for Major Transformation: Dilip Shanghvi

(4/30, Vikas Dandekar, The Economic Times) ...At an annual meeting of the USA-India Chamber of Commerce in Boston, Shanghvi told a gathering of leading multinational drug makers about the "clear positive improvements" that are taking place in India. Sun Pharma itself has built a pipeline of over 10 specialty and innovative drugs in the US. It's done this through acquisitions of late-stage drugs in clinical trials and building commercial teams around them. For Indian companies that have grown by making copies of innovative drugs, gaining presence in innovative drugs is considered tough as this segment is dominated by giant corporations such as Pfizer, Novartis, Roche, Eli Lilly and Bristol Myers Squibb... Full

Pharma PLI Needs to Be Revisited

(4/29, Reji K Joseph, The Hindu) ...An analysis based on UN Comtrade database, using a classification of pharmaceutical products based on International Standard Industrial Classification, shows that the reliance of countries on China has in fact increased during the post-pandemic period. China's share in global import of APIs has increased from 18 per cent in 2019 to 24 per cent in 2022. China's share in India's import of APIs has also increased, from 70 per cent to 72 per cent during the same period. Despite the assertions of supply source diversification, countries' reliance on China has increased... Sub. Req'd

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