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

 

Reality Check on Urothelial/Bladder Cancer 

Market access for urothelial/bladder cancer 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 24% of the lives under commercial formularies are covered with utilization management restrictions
  • Class Trends: In April 2019, the FDA gave accelerated approval to the Janssen Pharmaceutical Companies of Johnson & Johnson's Balversa (erdafitinib) 
  • Key Findings: Balversa, a tablet, is processed through the pharmacy benefit, while the rest of the products currently approved for urothelial cancer are primarily processed through the medical benefit. For provider-administered products, we see policies covering an entire class for an oncology indication when two or more products in a class carry an FDA-approved oncology indication  

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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