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MMIT Reality Check on HIV

Posted by Matt Breese on Dec 3, 2015

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

Payer Coverage: Almost three-quarters of U.S. lives are covered or better for integrase, protease and transcriptase inhibitors. However, payers do not list treatments on formulary for over one-tenth of lives.

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Source: MMIT data as of Q4 2015

Trends:  Robust treatments pipelines from pharmaceutical manufacturers provide hope for HIV/AIDS patients with 44 medicines in development, including 25 antivirals, 16 vaccines and 3 cell/gene therapies, according to a report from PhRMA. Great strides in clinical knowledge and development create more effective methods of early detection, simplified treatment options and preventing transmission.

Key Findings: Lack of utilization management for HIV/AIDS medicines results in greater access for patients. Unique to other specialty pharmaceutical classes, PA or step therapy policies are rare, aside from slightly more restrictions for health exchange formularies. Dozens of treatments crowd the landscape, although the five core groupings help to segment out the market. Since the 1990, the FDA approved at least 1 new antiretroviral drug each year. "Booster" drugs, fixed dose combinations and a new "maturation inhibitor" adjust the market access landscape as they arrive on the market.

In the full Reality Check on HIV 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