Formulary guidance and transparency from P&T to point of care

Which Disease Areas Are On Your Mind Going Into 2018?

Posted by Matt Breese on Dec 31, 2017

Find me on:

We reviewed activity across major disease areas featured in 2017 MMIT Reality Checks and gathered poll data from pharma brand teams to understand where the biggest buzz is within market access. The following disease areas (in order) is where we received the most interest - some of these surprised us...

If you're curious to read more about any of these disease areas, you can click on the pie charts to view the full Reality Checks.

1. Immunology (Rheumatoid Arthritis): 

  • Payer Insights: Increasing percentage of restricted lives for health exchange and medicare formularies
  • Class Trends: How biosimilar products will impact market access and prescribing
  • Key Findings: The significance of payer contracting and patient assistance programs in this disease area


2. Respiratory (Asthma/COPD): 

  • Payer Insights: Increasing percentage of restricted medicare lives on pharmacy benefit with a large amount of covered lives restricted on payer-controlled medical benefits
  • Class Trends: How pricing and reimbursement impacts prescribers and patients.
  • Key Findings: How market entrants are expected to drive more payer contracting


3. Antipsychotics:

  • Payer Insights: Increasing access restrictions on commercial formularies with the inverse trend for medicare formularies
  • Class Trends: How prescribers treat atypical antipsychotics different than first generation
  • Key Findings: A shift towards more integration of Medicaid benefits into managed care contracts and a slight decline of carve-out financing


4. Diabetes:

  • Payer Insights: Increasing percentage of restricted lives across commercial and health exchange formularies
  • Class Trends: The call for increased prescriber education in evidence-based treatment plans
  • Key Findings: How policy standardization continues to dominate diabetes formulary coverage and general access focus


5. Multiple Sclerosis

  • Payer Insights: Slight reductions in pharmacy benefit commercial and health exchange formulary restrictions
  • Class Trends: How neurologists now lead prescribing in the LTC segment and what this means for manufacturers
  • Key Findings: What makes coverage so complex in MS and why do dual-benefit products add both opportunity and risk?


We look forward to another great year. Don't miss a Perspectives, Reality Check or White Paper by subscribing for weekly notifications.

Subscribe for Weekly Perspectives

Topics: Specialty, Industry Trends, Market Access, Branding & Marketing