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Market Access Trends in LatAm: Lessons Learned from the Crowded T2D Market

Market Access Trends in LatAm: Lessons Learned from the Crowded T2D Market

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The type 2 diabetes (T2D) therapy market in Latin America (LatAm) presents a large commercial opportunity to drug manufacturers. The prevalence of T2D in LatAm is high and is expected to increase, and substantial unmet need remains. However, the already extensive treatment armamentarium for T2D means that any new entrants in the field will have to compete with established treatments. Unique market access hurdles and levers in Brazil, Mexico, and Argentina will determine the extent to which new brands achieve penetration in each of these countries. In the past seven years, several new oral and injectable non-insulin drugs—including DPP-IV inhibitors, GLP-1 analogues, and, most recently, SGLT-2 inhibitors—have launched in Brazil, Mexico, and Argentina, but their successful uptake is largely dependent on the expansion of drug coverage by local authorities, coverage that varies widely between countries. Health technology assessment (HTA) is rapidly becoming the most powerful driver of market access in Brazil, Mexico, and Argentina, and the premium prices of these newer classes of antidiabetic agents pose a major challenge to these cost-constrained healthcare systems. However, physicians and patients can resource exceptional pathways, some of which can lead to a drug’s inclusion in the national and/or institutional/regional drug formularies. Manufacturers of T2D agents should explore these opportunities to best position their products in these markets.

Questions Answered in This Report:

  • Understand the T2D market space in key LatAm markets. How do coverage/reimbursement status and resulting restrictions affect prescribing of key non-insulin antidiabetic agents, such as DPP-IV inhibitors and GLP-1 analogues, in Brazil, Mexico, and Argentina? Which of these agents is included in drug formularies of government-sponsored and/or social security programs? How does formulary listing affect prescribing in each market?

  • Analyze key LatAm payer insight into the coverage/reimbursement environment for current DPP-IV inhibitors and GLP-1 analogues and evaluate strategies to patient access to premium-priced T2D drugs in Brazil, Mexico, and Argentina. What factors are important for maximizing a premium-priced T2D agent’s market access potential in the cost-constrained LatAm environment? Given that premium-priced T2D agents lack nationwide coverage, what opportunities are within manufacturers’ reach to best position their drugs in these markets? Who are some of the key stakeholders in the path to formulary access in these countries?

  • Examine LatAm payer insight into current and emerging T2D treatments and their potential uptake. What are the market access hurdles that emerging agents will need to overcome in Brazil, Mexico, and Argentina? How do payers and prescribers perceive the emerging brands? To what extent do these brands address unmet clinical needs? How will payer policies in Brazil, Mexico, and Argentina affect uptake of emerging brands over currently approved drugs? What types of clinical and commercial advantages could secure coverage for emerging agents, according to payers? What market access levers can drug developers use to optimize positioning of their new brands? What weight will head-to-head and pharmacoeconomic outcomes have in the coverage of newly launched and emerging agents versus current mainstays?

Scope:

Markets covered: Argentina, Brazil, and Mexico.

Epidemiology: Country-specific prevalence of type 2 diabetes and obesity.

Primary research: Physician data and payer insights leveraged from Emerging Markets Physician and Payer Forum reports published in 2012 and 2013:

- More than 220 PCPs and endocrinologists surveyed in Brazil and Mexico; 51 PCPs and endocrinologists surveyed in Argentina.

- 19 payers participated in a phone interview; all interviewed payers are decision-makers involved in determining and regulating access to the key brands under study.

- Payer interviews provide insight from directors of purchase and supply at a private HMO in Brazil and coordinators of Brazil’s Programs for Pharmaceutical Assistance at ANVISA, coordinators of IMSS’s and ISSSTE’s Medical Programs in Mexico, and directors of special programs at different Obras Sociales in Argentina (among others).

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  • Pub Date: September 2014
  • Author(s): Andreia Ribeiro, Ph.D.

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