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MMIT Reality Check on HIV (Sep 2016)

Posted by Matt Breese on Sep 24, 2016

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According to our recent payer coverage analysis for HIV treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT's team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

Payer Coverage: A review of market access by channel shows that state medicaid formularies are much more restrictive as compared to commercial and health exchange formularies. A further analysis of utilization management across payer pharmacy benefit shows that the percentage of step therapies in the market is increasing:


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Source: MMIT data as of Q3 2016

Trends:  Recent news related to HIV treatments reveals the physician and patient perspective on therapy. A recent study shows the impact of physician-led programs around HIV awareness and prevention, and the need to adhere to the CDC's testing recommendations from a decade ago. When it comes to expensive treatments and the actual treatment for patients affected by HIV, physicians are guiding these patients to cheaper alternatives and procurement workarounds. From generic alternatives to coupons/patient assistance and specialty pharmacy networks and even free samples, patients find a way to get the medication they need.

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.

To read the full Reality Check on HIV treatments with key findings on clinical characteristics, HIV drug market access and payer coverage, please click on the button below: 

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View Reality Check

Topics: Specialty, Market Access, Payer, Branding & Marketing