HealthLeaders-InterStudy, a leading provider of managed care market intelligence, issued an incorrect press release on December 10 regarding the reimbursement status of Novartis' Exforge and Tekturna hypertension agents. Far from having stalled in gaining favorable access, these two agents have quickly penetrated Tier 1 and Tier 2 in U.S. formularies, with Exforge doubling the percentage of plans placing it on these tiers in just one year, and Tekturna almost tripled the percentage of plans giving it favored status. Likewise, the percentage of plans reimbursing Daiichi-Sankyo's Azor as a Tier 1 and Tier 2 agent has grown dramatically as well. The analysis includes a review of tier status of multiple plan types including commercial, employers and pharmacy benefit managers; Medicare and state Medicaid were excluded.
According to the new Formulary Forum report entitled Formulary Advantages in Hypertension: Penetration of Advantaged Tiers by Novel Agents and Fixed- Dose Combinations, these gains have come despite reticence on the part of pharmacy directors to reimburse some of these newer drugs.
"There may be a ceiling that these agents can reach in terms of favorable tier placement," says Jason Labonte, Ph.D., vice president at HealthLeaders- InterStudy. "Forty-four to 67 percent of managed care organization pharmacy directors surveyed favor use of individual (and often generic) drugs versus the newer single-pill, fixed-combination brands like Exforge and Azor. However, the past year of gains in favorable reimbursement for these agents certainly suggests they haven't hit that ceiling yet."
About Formulary Advantages in Hypertension: Penetration of Advantaged Tiers by Novel Agents and Fixed-Dose Combinations
The new Formulary Forum report is based on a survey of 50 pharmacy directors who control national, regional and state-level managed care organizations (MCO). Answers were segmented by type of plan to illustrate variances in strategy by size of plan. The easy-to-use PowerPoint format allows users to cut-and-paste graphs and data into their own presentations.
About Formulary Forum
Formulary Forum is the first and only source for identifying the trends in formulary positioning of competing agents, understanding why those trends were taking place and predicting what changes lay ahead for brand positioning in the face of both patent expiries and new drug launches. The new report series from HealthLeaders-InterStudy combines historical formulary data from Fingertip Formulary, which maintains the highest quality and most comprehensive, integrated database of formulary information in the United States, with a robust survey of 50 MCO pharmacy directors. The pharmacy directors responses reveal what events triggered movement of key brands within their formulary for a specific disease as well as what moves they expect to make in formulary structure as new brands enter the market.
About Fingertip Formulary
Fingertip Formulary (www.FingertipFormulary.com) offers comprehensive formulary data covering commercial, Medicaid, Medicare and PBM plans, among others, in the United States. Fingertip Formulary is a Decision Resources, Inc. company.
HealthLeaders-InterStudy, a Decision Resources, Inc. company, is the authoritative source for managed care data, analysis and news. For more information, please visit www.HL-ISY.com.
About Decision Resources, Inc.
Decision Resources, Inc. is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Both HealthLeaders-InterStudy and Fingertip Formulary are Decision Resources, Inc. companies. Please visit Decision Resources, Inc. at www.DecisionResourcesInc.com.
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