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Creative contracting initiatives key for pharma as competition in RA market increases
The rheumatoid arthritis payer market has experienced increasingly competitive forces, prompting RA drug manufacturers to experiment with new contracting initiatives to gain preferred formulary placement.
The rheumatoid arthritis (RA) payer market has experienced increasingly competitive forces, prompting RA drug manufacturers to experiment with new contracting initiatives to gain preferred formulary placement.
According to the Managed Care Message Monitor (MCMM) Rheumatoid Arthritis report (The Zitter Group), based on surveys of managed care payer organizations (n=79), representing 192 plans from February through July, 2011, the messages captured for RA products are focused more on contracting and rebates since fourth quarter 2010. In addition, contracting and cost discussions account for an increasing percentage of RA discussion at the expense of product safety and efficacy discussions.
According to the MCMM, RA is the fifth payer management priority discussed (6%), tied with multiple sclerosis (MS), which is also a therapeutic category with multiple high-cost agents. Payers identified the top RA drugs with the highest management priority are etanercept (#1); infliximab (#2); adalimumab (#3); rituximab (#6); abatacept (#24); and certolizumab pegol (#27).
The top MS agents are fingolimod (#4) and glatiramer (#5), according to the report. Although most RA specialty drug manufacturers are focused on contracting and differentiating their products in the current competitive market, Roche/Genentech and Pfizer are geared more toward educational strategies, and Pfizer is utilizing more medical science liaisons for this.
When unaided messages were discussed, formulary management topics and messages about infliximab were perceived by payers as more credible than other product messages, according to the report. Abbott's overall lead product adalimumab, its primary focus, is aimed at gaining preferred formulary status. Discussions of value-added and disease management programs, competitive messages, copayment issues, and rebating opportunities are reportedly perceived as positive. Etanercept messages center around its market leader status, including its distinct mechanism, predictable dosing, higher rebates for dosing limits, preferred formulary status, and contracting versus adalimumab and infliximab. For abatacept, the main focus is on the new subcutaneous (SC) formulation. Infliximab messages relate to contracting and management, while golimumab messages highlight product convenience (eg, auto-injector, SC, and once-monthly dosing). In the contracting arena, biopharma leader UCB touts rapid effectiveness for its certolizumab pegol, which is appealing to payers because "if a patient has no clinical response within 12 weeks, UCB will reimburse the plan for the cost of therapy."
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
