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

Formulary Coverage Changes for 2018 Medicare

Posted by Matt Breese on Oct 8, 2017

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Over the past couple of years, pharma has seen major shifts in how Medicare sponsors have changed their coverage methodologies. In addition, overall coverage of trending disease areas for Medicare formularies has shifted.

For instance, we've seen major shifts for asthma and COPD treatments within Medicare Part D - with a significant increase in the percentage of lives either not covered or restricted by PAs and step edits.


Heading into the fourth quarter, many pharmaceutical companies look to validate how "the word in the industry" will match actual Medicare formulary coverage changes in the coming year, for both their products and their competitors’. Without this validation, market access teams make forecasting and planning decisions based on intuition, not facts. 

Wouldn't it be great to have a radar on 2018 Medicare before Q1?

MMIT Radar on Medicare Advantage with our 2018 Medicare Preview enables brands and managed market teams to make data-driven decisions on Medicare rebate strategy and sales planning in the fourth quarter. MMIT's clients can verify and correct contracted coverage to eliminate any risk in errors being reported which could result in lost sales early in 2018.

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Preview 2018 Coverage

  • 2018 Medicare formulary statuses with reporting visualizations to understand national and regional changes in coverage
  • 2018 NEW Medicare formulary offerings with validated coverage to help with strategic account planning

Know What’s Happening in Medicare All Year

  • Ongoing Perspective about market trends in all government channels
  • Share insights in the industry that could impact your brand's performance in key markets

As the Medicare market becomes more complicated, MMIT strives to understand and educate pharma, payers and prescribers on important coverage changes. Our experts manage Medicare formularies and analyze Medicare coverage to help pharma companies succeed.

Learn More About MMIT Radar on Medicare Advantage

Topics: Specialty, Industry Trends, Market Access