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MMIT Reality Check on Dermatology: Acne

Posted by Matt Breese on Feb 5, 2016

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Touching a network across healthcare in pharma, payer and provider, MMIT's team of experts takes a closer look at acne treatments in our most recent Reality Check. The following brief highlights some of our key takeaways from the piece.

Payer Coverage: A review of market access for dermatology treatments reveals the degree of restricted reimbursement. Advantaged product access usually results from PAs (that exist for 1/5 of lives) or step therapies (that exist for 1/3 of lives).

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Source: MMIT data as of Q1 2016

Trends: Historically, dermatologists were categorized as pharma rep-friendly specialists. However, roughly 20% less HCPs are welcoming reps each year, supported by year-over-year data from ZS Associates. Another trend is the penetration of dermatological devices in the landscape. First Report Managed Care via HMP Communications calls out that the dermatology devices market is expected to grow by $4 billion by 2019. Depending on market position, some pharmaceutical manufacturers view these technologies as welcome supplements while other perceive new devices as competition.

Key Findings: A closer look at the acne landscape reveals complex reimbursement restrictions, market access variance by channel, and advancing promotional strategies. The prevalence of prior authorization and step therapy requirements creates challenges for treatments. An incredible 88% of prior authorization policies from top payers are restrictive-to-label. While commercial formularies feature a significant percentage of preferred lives and managed medicaid covers acne products for roughly 94% of lives, Medicare Part D coverage is the most restrictive with only 30% of lives covered. To overcome access challenges, both from payer formularies and from physical interactions with doctors, manufacturers implement more innovative promo strategies, such as non-personal promotion.

In the full Reality Check on acne treatments below, MMIT's team of experts takes a deeper look into the clinical characteristics, drug market access and payer coverage to summarize key findings within the class.

View Reality Check

Topics: Market Access