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MMIT Reality Check on Antipsychotics (Oct 2017)

Posted by Matt Breese on Oct 5, 2017

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According to our recent payer coverage analysis for atypical antipsychotic 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 look at market access over the past two quarters shows the increasing amount of restricted commercial lives and an inverse trend for Medicare formularies. On the medical benefit side, atypical antipsychotics have much more favorable access on average. While Medicare and Health Exchange channels restrict coverage for over one-quarter of lives, commercial coverage is strong.


Source: MMIT data as of Q4 2017

Trends:  This indication is experiencing a shift towards more integration of Medicaid benefits into managed care contracts and a slight decline in the use of carve-out financing. Payers implement a variety of pharmacy benefit and medical benefit coverage for injectable antipsychotics, whereas oral treatments process exclusively through pharmacy benefit. 

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


View Reality Check


Topics: Specialty, Market Access, Branding & Marketing