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MMIT Reality Check on Cystic Fibrosis (April 2016)

Posted by Matt Breese on Apr 21, 2016

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

Payer Coverage: An analysis of payer pharmacy benefit coverage shows that, while step therapies aren't too common, products still face restrictions in the form of prior authorizations and challenging tier placement. However, when step therapies do exist, nearly half of policies require multiple product steps.cystic-fibrosis-reality-check.png

Source: MMIT data as of Q2 2016

Trends:  Recent news related to cystic fibrosis pharmaceuticals highlights some key trends in this therapeutic area. One of the most significant advancements in this class is the introduction of agents that target CFTR protein abnormalities. Since the introduction of Kalydeco in 2012, these modulators rapidly establish their place in the class. This new group of products will soon be supplemented by a couple of treatments, rapidly moving through the pipeline. These products will also help treat a greater percentage of the population.

Key Findings: MMIT's pharmacists reveal several key findings when taking a closer look at the market access data for cystic fibrosis treatments. The introduction of innovative treatments definitely impacts the overall market access share in the class. Cystic fibrosis transmembrane conductance regulators (CFTR) agents gain pick up advantaged access across many channels and geographies but still face a significant percentage of restrictions, predominantly in the form of prior authorizations. Over the next five years, several new market entrants will offset the effects of key patent losses. Additionally, the introduction of new drug deliver methods also drives the accelerated adoption of these products. As treatment prices increase, payers display significant resistance to product access. Pharma companies rely heavily on targeted top payer contracting to diffuse restrictive utilization management and tier placement.

In the full Reality Check on cystic fibrosis products 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