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


Reality Check on Pain Narcotic Opioid Q2 2020

Market access for pain narcotic opioid 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 35% of the lives under commercial formularies are covered with utilization management restrictions
  • Class Trends: When Medicare Part D plans fail to cover opioid alternatives, it may encourage higher rates of opioid prescribing, according to a study published in JAMA Network Open. Researchers found that "for each additional opioid alternative not covered in a county, the rate of opioid prescribing increased by 2.2% to 3.7% relative to the mean opioid prescribing rate."
  • Key Findings: Many brand name products (Xtampza ER, Oxaydo) continue to enter this market despite the numerous generics. Given assumed parity in efficacy among remaining name-brand products, contracting for position after a generic is common

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.