Contact

Payer

Pharma

Provider

Formulary guidance and transparency from P&T to point of care

MMIT Reality Check on Antipsychotics (June 2016)

Posted by Matt Breese on Jun 13, 2016

Find me on:

MMIT's team analyzes the market access landscape for antipsychotic treatments in our most recent Reality Check. The following brief highlights some of our key takeaways from the piece.

Payer Coverage: A review of the branded drug landscape for U.S. payer pharmacy benefit lives demonstrates the difference in formulary coverage by channels. Medicare and health exchange formularies restrict the greatest percentage of lives. When it comes to reimbursement restrictions, around 60% of payer pharmacy benefit PAs are restrictive to the FDA approved label.kantar-antipsychotic-schizo-treatments.png

Source: MMIT data as of Q2 2016

Trends: Recent news related to antipsychotic treatments highlights some key trends in this therapeutic area. Many drugmakers implement unique approaches for drug promotion in the antipsychotic landscape. Stakeholders are particularly sensitive to patient and physician messaging regulations and allocate significant resources to promotional compliance, according to a recent article from The Journal of the American Medical Association. The increasing amount of drugs in the antipsychotic landscape, including branded and generic treatments, creates significant competition. However, recent research reveals that alternative treatment methods, such as talk therapy sessions, are also gaining market share.

Key Findings: Manufacturers approach the antipsychotics treatment landscape with novel therapies, primarily indicated for schizophrenia and bipolar disorder. New players from the emerging pharma space expect to grab market access share as they enter the market. New or old, most products deal with restricted payer reimbursement, primarily in the form of restrictive PAs, which exist for roughly two-thirds of total PA policies. Finally, the presence of generic treatments and a substantial number of competitors creates a diverse geographical market access landscape picture, specifically when it comes to Medicaid carve-outs.

In the full Reality Check on antipsychotics 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