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MMIT Reality Check on Detoxification Agents (May 2016)

Posted by Matt Breese on May 27, 2016

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MMIT's team analyzes the market access landscape for detoxification agents in our most recent Reality Check. The following brief highlights some of our key takeaways from the piece.

Payer Coverage: A market access review of detoxification agents reveals that top payers restrict access differently for the product indicated for both conditions in this class. A review of pharmacy benefit data reveals that payers implement appropriate opioid dependence PA policies when a PA exists. However, roughly 1/3 of PAs for alchohol deterrence are restrictive to the FDA approved label when present.reality-check-detox-may.png

Source: MMIT data as of Q2 2016

Trends: Recent news related to detoxification agents highlights some key trends in this therapeutic area. The arrival of treatments like Probuphine (the first implant of its kind), that address opioid dependence in new innovative ways could shift the class landscape, as well as inspire manufacturers in other therapeutic areas to follow suit. Current branded opioid deterring products deal with a competitive landscape. Market events, such as Suboxone going generic, allow for more large manufacturers to enter the playing field. Additionally, the coverage of products like Naloxone adds more complexity to an already complex landscape.

Key Findings: The detoxification agents pipeline includes novel delivery mechanisms and long-acting formulations that could result in major prescribing shifts. A review of market access at the state levels reveals significant trends in product advantages. Effective payer contracting and state-run programs help promote the adoption of certain brands. Primarily, payers cover products under pharmacy benefit. However, long-acting formulations like Vivitrol process through medical benefit for roughly one-third of top payer lives, adding an additional level of market access complexity.

In the full Reality Check on detoxification agents 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