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MMIT Reality Check on Hepatitis C

Posted by Matt Breese on Dec 28, 2015

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Key insights and data direct from health plans reveals the following market access analysis of Hep C treatments in our most recent Reality Check. For the full piece piece, click here.

Payer Coverage: A review of market access for Hepatitis C treatments reveals roughly 75% of U.S. lives maintain a covered or better formulary status. However, top payers place drugs on a specialty drug tier for around 22% of lives. 

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Source: MMIT data as of Q4 2015

Trends: Fortunately, new treatments cure Hepatitis C for nearly 100% of the patients who can afford them. Drug development now shifts to curing the disease quicker and at a more affordable price, per a recent article from WebMD. A review of the available treatments in this space from the patient perspective describes drug side affects as the most significant source of product differentiation.

Key Findings: A review of the past year demonstrates the power of effective manufacturer contracting with payers in the Hep C market. Prior to arrangements between Express Scripts and Abbvie as well as CVS Health and Gilead, many payer policies limited access to newer, costlier agents to patients with advanced stage cirrhosis. The introduction of "cures" into the market generates a new dynamic for preferred market access. The newer products in the space saw a steep increase in advantaged access after launch while existing treatments' access declined. Hepatitis C manufacturers continue expanding the scope of treatments available to the consumer. Developing products from Merck and J&J/Achillion Pharmaceuticals should result in an even more dynamic class.

In the full Reality Check on Hepatitis C 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