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

 

Reality Check on HeFH

Market access for HeFH treatments reveals differences in payer coverage across each major channel, as well as specific trends in the drug landscape.  

To help make sense of this new research, MMIT's team of experts has analyzed the data for you and summarized the key findings:

  • Payer Insights: Under the pharmacy benefit, about 66% of the lives under commercial formularies are covered with utilization management restrictions  
  • Class Trends: In February 2020, the FDA approved Esperion Therapeutics, Inc.’s Nexletol (bempedoic acid) tablet, a once-daily, non-statin LDL-cholesterol-lowering medicine, for the treatment of adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease who require additional lowering of LDL-C
  • Key Findings: Coverage is highly restricted with multiple steps and a laundry list of prior-authorization restrictions. All products are covered under the pharmacy benefit, but some also have medical coverage, which is rarely used by health care providers or the pharma companies

What can pharma do to curb this trend and overcome these challenges?

Get the data behind this change and how it could impact your market access plans from MMIT's team. Their clinical and policy backgrounds provide a unique and expert perspective to help expand your knowledge in the class and guide your decision-making process.

Download the full Reality Check now.

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