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


Reality Check on HIV

Market access for HIV 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 78% of the lives under commercial formularies are covered without utilization management restrictions
  • Class Trends: In September 2019, the FDA expanded the indications of Pifeltro (doravirine) in combination with other antiretroviral agents and Delstrigo (doravirine/lamivudine/tenofovir disoproxil fumarate) as a complete regimen to treat adults with HIV-1 infection who are virologically suppressed on a stable antiretroviral regimen with no history of treatment failure and no known substitutions associated to resistance to Pifeltro or Delstrigo's components
  • Key Findings: Contracting is prevalent for drugs in the same HIV grouping, with most activity focused on tiering preference. The designation as a protected Medicare class ensures good coverage for branded agents and more rapid inclusions on formularies

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.