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

MMIT Reality Check on HIV (Feb 2018)

Posted by Matt Breese on Feb 2, 2018

Find me on:

According to our recent payer coverage analysis for HIV 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: Coverage for commercial formularies varies slightly across the 3 major HIV drug categories (Integrase, Protease and Transcriptase). Over the past two quarters, we see a reduction in restrictions for protease inhibitors. However, we see an increase in restrictive PAs for transcriptase inhibitors.


Source: MMIT data as of Q1 2018

Trends:  Read a variety of perspectives on 2018 changes for the HIV disease area, which differs amongst patients, HCPs, manufacturers and industry influencers. One post from AIS Health's Specialty Pharmacy News provides one perspective from Reg Blackburn from The Braff Group: Within the specialty space, “some HIV drugs are going generic,” which is “certainly a positive thing,” as specialty drugs don’t go generic very often, he says. And while biosimilars are not the same as generics, “how they evolve this year, their payment structure, adoption and impact on pricing” will be “something to watch.” Once patients are stabilized on a specialty drug, switching them to another therapy is “not a simple thing.”

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


View Reality Check

Topics: Specialty, Market Access, Payer, Branding & Marketing