Speciality

MMIT Reality Check on Atopic Dermatitis (May 2021)

May 14, 2021

According to our recent payer coverage analysis for atopic dermatitis treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

According to our recent payer coverage analysis for atopic dermatitis 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 atopic dermatitis treatments shows that under the pharmacy benefit, about 23% of the lives under commercial formularies are covered with utilization management restrictions.

Trends: Sanofi and Regeneron’s Dupixent (dupilumab) and Pfizer Inc.’s Eucrisa (crisaborole) are competing for preferred status after topical corticosteroids and topical calcineurin inhibitors and phototherapy. Numerous companies are poised to enter the same market space, many with new biological agents.

by Matt Breese

Radar on Market Access: AllianceRx Walgreens Prime/Highmark Partner to Target SDOH Barriers for People With MS

May 13, 2021

Recently, health insurers have begun focusing on social determinants of health (SDOH) and the role these factors play on health outcomes. Then the COVID-19 pandemic put even more of a spotlight on the issue, disproportionately affecting people of color and low-income communities. Recognizing the impact that SDOH can have, AllianceRx Walgreens Prime is partnering with Highmark Inc. to launch a pilot outreach program focused on the impact of SDOH on people with multiple sclerosis (MS), AIS Health reported.

The program will apply to Highmark members with an MS diagnosis who use AllianceRx Walgreens Prime as their specialty pharmacy. To participate, these members must be willing to take part in a 13-question, voluntary survey conducted via telephone. SDOH-trained nurses from AllianceRx Walgreens Prime are contacting eligible members by phone and offering to administer the survey. Highmark will assess the survey responses to identify how it can design a specific care plan for each member facing SDOH challenges.

Recently, health insurers have begun focusing on social determinants of health (SDOH) and the role these factors play on health outcomes. Then the COVID-19 pandemic put even more of a spotlight on the issue, disproportionately affecting people of color and low-income communities. Recognizing the impact that SDOH can have, AllianceRx Walgreens Prime is partnering with Highmark Inc. to launch a pilot outreach program focused on the impact of SDOH on people with multiple sclerosis (MS), AIS Health reported.

The program will apply to Highmark members with an MS diagnosis who use AllianceRx Walgreens Prime as their specialty pharmacy. To participate, these members must be willing to take part in a 13-question, voluntary survey conducted via telephone. SDOH-trained nurses from AllianceRx Walgreens Prime are contacting eligible members by phone and offering to administer the survey. Highmark will assess the survey responses to identify how it can design a specific care plan for each member facing SDOH challenges.

“Based on the self-identified needs of the member, the Highmark Social Work team will outreach to further assess the SDOH issue or barriers,” explains Amy Shannon, director of health and wellbeing integration at Highmark.

“SDOH can drive up to 80% of an individual’s health outcomes,” she says. “It’s imperative that we assess and provide support to members who are facing SDOH issues.”

According to Rick Miller, BS.Pharm., MS.Pharm., vice president of clinical and professional services at AllianceRx Walgreens Prime, the pilot is focusing on seven domains: “social connections, financial resource strain, health literacy, food insecurity, transportation needs, safety and housing stability. While these SDOH domains may impact any patient with a health condition, in the short time the pilot has been live, we have already identified transportation needs, housing stability and financial resource strain as concerns within the MS population.”

The program will run for one year. Depending on its success, additional patient populations may be included in future phases. “We are exploring a number of specialty disease states for future expansion,” says Miller. “Initial expansion would focus on chronic specialty therapies, as well as specialty disease states, such as oncology and autoimmune diseases, that can be complex and challenging for patients to navigate through the health care system.”

by Angela Maas

 

MMIT Reality Check on Narcolepsy (May 2021)

May 7, 2021

According to our recent payer coverage analysis for narcolepsy treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

According to our recent payer coverage analysis for narcolepsy 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 narcolepsy treatments shows that under the pharmacy benefit, about 54% of the lives under commercial formularies are covered with utilization management restrictions.

Trends: In October 2020, the FDA gave another approval to Harmony Biosciences Holdings, Inc.’s Wakix (pitolisant) for the treatment of cataplexy in adults with narcolepsy. The agency initially approved the selective histamine 3 (H3) receptor antagonist/inverse agonist on Aug. 15, 2019.

by Matt Breese

MMIT Reality Check on Anemia — Chronic Kidney Disease (Apr 2021)

April 30, 2021

According to our recent payer coverage analysis for anemia treatments due to chronic kidney disease, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

According to our recent payer coverage analysis for anemia treatments due to chronic kidney disease, 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 anemia treatments due to chronic kidney disease shows that under the pharmacy benefit, about 39% of the lives under commercial formularies are covered with utilization management restrictions.

Trends: New-to-market products will have to compete with well-established erythropoiesis-stimulating agents and a biosimilar, as well as an IV iron replacement product for people not on dialysis. Products with improved side-effect profiles compared with ESAs will have an advantage.

by Matt Breese

MMIT Reality Check on Hemophilia B (Factor IX) (Apr 2021)

April 23, 2021

According to our recent payer coverage analysis for hemophilia B (factor IX) treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

According to our recent payer coverage analysis for hemophilia B (factor IX) 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 hemophilia B (factor IX) treatments shows that under the pharmacy benefit, about 37% of the lives under commercial formularies are covered with utilization management restrictions.

Trends: Anticipated product approvals may develop improved product placement based on potential cost, adherence and efficacy advantages. The hemophilia market will be managed more tightly as we start seeing an increase in long-acting products.

MMIT Reality Check on Growth Hormone Deficiency (Apr 2021)

April 16, 2021

According to our recent payer coverage analysis for growth hormone deficiency (GHD) 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.

According to our recent payer coverage analysis for growth hormone deficiency (GHD) 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 growth hormone deficiency treatments shows that under the pharmacy benefit, about 55% of the lives under commercial formularies are covered with utilization management restrictions.

Trends: When the FDA approved Novo Nordisk, Inc.’s Sogroya (somapacitanbeco) for the replacement of growth hormone in adults with growth hormone deficiency in August 2020, it became the only long-acting agent on the market. A survey by Zitter Insights shows that many endocrinologists expect to shift prescribing to such agents from the short-acting growth hormones.