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

 

Reality Check on Schizophrenia

Market access for schizophrenia 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 26% of the lives under commercial formularies are covered with utilization management restrictions
  • Class Trends: In December 2019, the FDA approved Intra-Cellular Therapies, Inc.’s Caplyta (lumateperone) for the treatment of schizophrenia in adults. The drug is an oral, once-daily medicine and is being developed for the treatment of bipolar depression; behavioral disturbances in patients with dementia, including Alzheimer’s disease; depression; and other neuropsychiatric and neurological disorders
  • Key Findings: Coverage is primarily under the pharmacy benefit, but medical benefit coverage is available for some medications. Coverage is restricted for most brand name oral atypical antipsychotics, which will require a step through generic products

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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