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MMIT Reality Check on Antipsychotics

Posted by Matt Breese on Jan 28, 2016

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

Payer Coverage: Payers place top injectable antipsychotics on a combination of pharmacy benefit and medical benefit for U.S. lives. Top payers list these treatments on both pharmacy benefit and medical benefit for roughly half of covered U.S. lives. The remaining coverage favors medical benefit over pharmacy benefit.reality-check-antipsychotic.png

Source: MMIT data as of Q4 2015

Trends:  Many drugmakers implement unique approaches for drug promotion in the antipsychotic landscape. Stakeholders are particularly sensitive to patient and physician messaging regulations and allocate significant resources to promotional compliance, according to a recent article from The Journal of the American Medical Association. The increasing amount of drugs in the antipsychotic landscape, including branded and generic treatments, creates significant competition. However, recent research reveals that alternative treatment methods, such as talk therapy sessions, are also gaining market share.

Key Findings: Manufacturers approach the antipsychotics treatment landscape with novel therapies, primarily indicated for schizophrenia and bipolar disorder. New players from the emerging pharma space expect to grab market access share as they enter the market. New or old, most products deal with restricted payer reimbursement, primarily in the form of restrictive PAs, which exist for roughly two-thirds of total PA policies. Finally, the presence of generic treatments and a substantial number of competitors creates a diverse geographical market access landscape picture, specifically when it comes to Medicaid carve-outs.

In the full Reality Check on antipsychotic 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