MMIT Reality Check on Cystic Fibrosis (Jan 2020)

According to our recent payer coverage analysis for cystic fibrosis 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 review of market access for cystic fibrosis treatments shows that under the pharmacy benefit, almost 45% of the lives under commercial formularies are covered with utilization management restrictions.

Trends: Cystic fibrosis transmembrane conductance regulator (CFTR) modulators (Vertex Pharmaceuticals’ Trikafta, Symdeko, Orkambi and Kalydeco) are the first type of CF therapy to treat the root cause of the disease rather than the symptoms. Although costly, these therapies have made a large impact on market value.

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AIS Health Staff

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