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

MMIT Reality Check on Cystic Fibrosis

Posted by Matt Breese on Nov 19, 2015

Find me on:

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

Payer Coverage: A large percentage of the CF population requires enzyme replacement therapy. This market access snapshot shows the average drug coverage for two indications. U.S. payers list approximately 30% of CF treatments under specialty.


Source: MMIT data as of Q4 2015

Trends:  As a result of advancing care in CF, more patients can expect to live longer. According to a recent study, an additional 75% of CF patients will live into adulthood, which will require the health system to make significant changes to accomodate the shift. Additionally, experts predict that treatments currently in the CF pipeline could have more widespread application and help thousands of people.

Key Findings: Over the course of the next five years, key patents will expire; however, the new products ought to balance the losses. Although product access has remained stable historically, the wider reach and effectiveness of new drugs will increase the base. CFTR modulators will also help treat the actual disease in addition to mitigating symptoms. Although additional treatment options help patients, they complicate payer coverage. Especially as treatment prices rise, payers will likely limit product access.

In the full Reality Check on cystic fibrosis 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