Neuropathic pain (NP) is a heterogeneous disorder arising from a wide variety of diseases and conditions, and as a result, patient response to drug therapy is often unpredictable. Despite the need for new products in this space, such therapies will struggle to clinically differentiate themselves from current therapies, and a growing generic presence across multiple drug classes will result in increasing market access challenges for branded therapies. In this Access & Reimbursement analysis, how market access barriers shape treatment for NP in the United States is explored, based on collective insight from 100 physicians and 30 MCO PDs/MDs with influence in reimbursement and access of key agents used to treat NP.

Questions Answered

  • What are the current drivers and barriers to prescribing NP therapies in the United States, and how do cost and reimbursement pressures or clinical concerns restrict prescribing of current treatments for NP?
  • What formulary coverage do key NP therapies receive, and what approaches do payers employ to manage utilization and costs?
  • How are MCO PDs/MDs performing value assessments for therapies, and what are the preferred pharmacoeconomic models?
  • What will be the impact of Pfizer’s pregabalin CR on NP reimbursement dynamics, and how will the emergence of future generic pregabalin formulations impact formulary and prescribing decisions?
  • How will emerging therapies (e.g., Biogen’s BIIB-074) be reimbursed and prescribed in an increasingly genericized NP market?

Product Description

Access & Reimbursement provides in-depth insight regarding the impact of payer policy on physician prescribing behavior so you can build your market access strategy and optimize your brand positioning.

Markets covered: United States

Primary research:

  • Survey of 50 PCPs, 25 pain specialists, and 25 neurologists in the United States.
  • Survey of 30 U.S. managed care organization (MCO) pharmacy and medical directors (PDs/MDs).

Key companies: Acorda Therapeutics, Biogen, Depomed, Janssen, NeurogesX, Pfizer, Purdue Pharma, Validus Pharmaceuticals,  XenoPort

Key drugs: Lyrica/Lyrica CR, Gralise, Horizant, Equetro, Nucynta ER, OxyContin, Qutenza, vixotrigine (BIIB-074)

Content highlights:

  • Reimbursement and contracting.
  • Access and prescribing.
  • Special topics.
  • Opportunities and challenges for emerging therapies.

Table of contents

  • Neuropathic Pain - Access & Reimbursement - Detailed, Expanded Analysis (US)

Author(s): Natalie Taylor, PhD; Andrea Witt; Audreza Das, P.G. Dip. ; Chris Lewis

Natalie Taylor, Ph.D. is a Principal Business Insights Analyst with the central nervous system/ophthalmology disorders team at Decision Resources Group. She has over ten years of experience authoring primary and market research reports for pharmaceutical industry clients across multiple psychiatry, pain, neurology, and ophthalmology therapy areas.

Prior to joining DRG, Dr. Taylor worked at QuintilesIMS as manager of the central nervous system portfolio of Disease Insights market forecasting offerings. She completed her Ph.D. in Physiology at Dartmouth College in Hanover, New Hampshire, where she studied the role of serotonergic neurons in the medullary raphe on modulating respiratory responses in mammals. She holds a B.S. in Biology from Dickinson College in Carlisle, Pennsylvania.

Audreza Das is a Senior Analyst in the CNS/Ophthalmology team at Decision Resources Group

She has authored content across indications, including neuropathic pain, age-related macular degeneration, treatment-related depression, painful diabetic neuropathy, and migraine. Ms. Das has previously worked at Novo Nordisk, as a Market Analyst for European markets. Previous experience at a SME, included developing disease competitive landscapes, covering global conferences etc. Ms. Das received her B.E. degree in Biotechnology from Birla Institute of Technology, a deemed university and her P.G. Diploma in Cancer Immunology & Biotechnology from University of Nottingham.

Chris Lewis serves as primary research manager, U.S. Access and Reimbursement, with responsibility for coordination, content review and content generation of the market access and reimbursement insights at DRG. Content is based on online surveys of managed care organizations and physicians and expert analysis of reimbursement and prescribing patterns of key therapies treating various disease states.

Lewis was an analyst/senior analyst for the group’s HealthLeaders-InterStudy subsidiary for eight years, specializing in the managed care and pharmacy benefit management industries. Throughout her tenure, she has produced the Health Plan Analysis reports for California, New York, New Jersey, Connecticut, and Pennsylvania and authored DRG’s series of pharmacy benefit manager profiles. She has also conducted numerous webinars for the group. She is a seasoned journalist with a B.A. in communications from California State University, Sacramento.


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