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


Reality Check on Rheumatoid Arthritis

Market access for rheumatoid arthritis 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 71% of the lives under commercial formularies are covered with utilization management restrictions
  • Class Trends: In November 2019, the FDA approved Pfizer Inc.’s Abrilada (adalimumab- afzb) for the treatment of rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, adult Crohn’s disease, ulcerative colitis and plaque psoriasis. It is the fifth biosimilar of AbbVie Inc.’s Humira (adalimumab) that the agency has approved
  • Key Findings: The medical and pharmacy benefits are both present for many products, with even infusions covered under the pharmacy benefit. The cost and prevalence of treating RA have led to PBMs and plans instituting complex step-management techniques, which result in many variations of coverage and step statements

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.