Key insights and data direct from health plans reveals the following market access analysis of detoxification agents in our most recent Reality Check. For the full piece piece, click here.
Payer Coverage: Top payers restrict access differently for products indicated for both alcohol deterrence and opioid dependence. A review of utilization management shows that 1/3 of PAs for alcohol deterrence products are restrictive-to-label whereas all PAs in opioid dependence are appropriate for top payers requiring a prior authorization.
Source: MMIT data as of Q4 2015
Trends: Patients now have multiple branded and generic options, creating a much more competitive market landscape for manufacturers entering the detoxification agent market basket, according to in-Pharma Technologist. Long-lasting agents like Vivitrol shift prescribing habits for HCPs based on the treatment environment. Additional long-lasting products and unique delivery devices expect to join the market basket in coming years.
Key Findings: The detoxification agents pipeline includes novel delivery mechanisms and long-acting formulations that could result in major prescribing shifts. A review of market access at the state levels reveals significant trends in product advantages. Effective payer contracting and state-run programs help promote the adoption of certain brands. Primarily, payers cover products under pharmacy benefit. However, long-acting formulations like Vivitrol process through medical benefit for roughly one-third of top payer lives, adding an additional level of market access complexity.
In the full Reality Check on detoxification agents 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.