Formulary Advantages in Osteoporosis: Rise and Fall of Access in the Wake of Fosamax Generics, Rebate and Contracting Efforts, and New Drug Launches
With 62 million cases of osteoporosis and osteopenia in the United States and a U.S. market of over $3.8 billion, few brands are competing for a very large
appropriation of healthcare dollars. Major brands, however, now have to contend
with generic alendronate (Merck’s Fosamax, generics) and convince payers that
their brand provides a sufficient value proposition for Tier 2 reimbursement. More
recently, the osteoporosis market in the United States has seen growing
uncertainty as Amgen’s Prolia (denosumab) received a favorable ruling from an
FDA advisory panel, and Eli Lilly announced discontinuation of Phase III
clinical development of arzoxifene.
Using tiering and restrictions data from Fingertip Formulary,
as well as insight from 50 pharmacy directors, this report determines the key
trends in reimbursement in osteoporosis, drivers of these trends, and how
stakeholders can capitalize on future shifts in coverage to steal share from
the competition.
