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


Reality Check on Ophthalmic Anti-Inflammatory

Market access for ophthalmic anti-inflammatory 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, almost 57% of the lives under commercial formularies are covered without utilization management restrictions
  • Class Trends: In March 2020, Noveome Biotherapeutics said it will evaluate its ST266, a first-of-its-kind cell-free platform biologic drug that was initially developed for ophthalmology indications, as a potential treatment of severe cytokine storm associated with COVID-19
  • Key Findings: There is good coverage for this indication, which is under the pharmacy benefit, and a wide variety of generics are available. Prior authorization for Medicaid plans usually requires a diagnosis, while commercial coverage criteria often require stepping through generic or preferred agents

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.