Type 2 diabetes is a leading cause of cardiovascular disease, blindness, renal failure and neurologic dysfunction in the United States. Current epidemiologic studies estimate that nearly 24 million Americans have type 2 diabetes and another 57 million have impaired glucose tolerance known as "pre-diabetes." On the whole, therapies for the treatment of type 2 diabetes receive widespread, restriction-free reimbursement on low formulary tiers because health plans understand the value of early and aggressive glycemic control. Nonetheless, patent expiry of several branded anti-diabetic therapies over the next three years, most-notably Takeda's Actos, will not only lead to in-class generic erosion, but will likely negatively impact reimbursement of all branded oral therapies and GLP-1 inhibitors.
Using tiering and restrictions data from Fingertip Formulary, as well as insight from 44 pharmacy directors, this report determines the key trends in reimbursement of type 2 diabetes treatments, drivers of these trends, and how stakeholders can capitalize on future shifts in coverage to steal share from the competition.