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


Reality Check on Type 2 Diabetes (GLP-1 and Combo) 

Market access for type 2 Diabetes (GLP-1 and Combo) 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 37% of the lives under commercial formularies are covered with utilization management restrictions
  • Class Trends: With the cost of diabetes drugs still growing, PBMs and payers are looking for more innovative strategies to hold down costs. For some, that might include a strategy similar to the one unveiled by CVS Health Corp.’s Caremark unit in 2020. The plan, called RxZERO, offers a slimmer formulary for the diabetes drug class, but with no out-of-pocket costs for members
  • Key Findings: Coverage for the drugs is via the pharmacy benefit. This is a heavily contracted class; costs are high, but so are rebates. Step-therapy restrictions are common, either alone or as part of prior authorization

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.