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MMIT Reality Check on Narcotic Pain

Posted by Matt Breese on Nov 25, 2015

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

Payer Coverage: Narcotic pain treatments are covered for four out of five U.S. covered lives, based on an average of all branding products in the class. 


Source: MMIT data as of Q4 2015

Trends:  Many groups accross pharma push for additional oversight into narcotic pain prescription drugs. According to a recent report, Johns Hopkins advocates for increased transparency and to give PMDM list access to PBMs. Additionally, pain's unquantifiable nature creates problems for preventing opioid addiction, as chronic pain might necessitate long-term opioid use. In order to prevent addiction when possible, pharma utilizes abuse-deterrent treatments whenever possible.

Key Findings: Especially considering the Obama administration's push to reduce opioid addiction and abuse, pharma expands their use of abuse-detterant treatments for new products. Additionally, the narcostic pain class contains many generic solutions. Branded products must typically step through generic medications first. Payers also have tremendous restrictions, requiring prior authorizations and step therapies for sizable portions of covered lives.

In the full Reality Check on narcotic pain 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