Alzheimer’s Disease – Access & Reimbursement – Access & Reimbursement – Alzheimer’s Disease (US)

Eisai / Biogen’s Leqembi (lecanemab) and Eli Lilly’s Kisunla (donanemab) are vying to capitalize on the potential for a disease-modifying therapy (DMT) in Alzheimer’s disease (AD), and additional anti-Aβ monoclonal antibodies (MAbs) (e.g., Roche’s trontinemab) will drive competition and expand treatment choices for patients. Lundbeck / Otsuka’s Rexulti became the first FDA-approved drug to treat agitation in AD, and other novel therapies (i.e., Axsome’s Auvelity) for this condition are advancing. Understanding neurologists’ preferences and expectations for new therapeutics and payers’ receptivity to high-priced brands in this underserved and heavily generic market is key for developers with agents in the large AD pipeline.

Questions answered

• What is the state of coverage of Leqembi, Kisunla, Rexulti, and other AD brands? What restrictions do payers impose, and how do market access dynamics influence surveyed neurologists’ prescribing?
• What coverage and uptake are expected for emerging therapies (i.e., Axsome’s Auvelity, BMS’s KarXT, Roche’s trontinemab, Eli Lilly’s remternetug, Eisai / Biogen’s SC lecanemab, Novo Nordisk’s semaglutide)? What clinical and nonclinical differentiators would drive preferential use and coverage terms?
• What is the state of coverage for AD diagnostics (e.g., Aβ PET scans, blood-based biomarkers), and how are physicians using them?

Product description

Leveraging Clarivate’s proprietary data sources and surveys with physicians and payers, Access & Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of payer policy on physician prescribing behavior in the United States. Through detailed analyses of drug coverage, restriction policies, and contracting, as well as payer and prescriber perspectives on key marketed drugs and their receptivity to emerging therapies, this report enables you to:

• Identify and learn how to overcome roadblocks to market access to best position your brand.
• Identify key stakeholders and reimbursement drivers and assess the impact that reimbursement decisions have on treatment selection.
• Evaluate competitor strategies for securing favorable market access terms.

Markets covered: United States

Key drugs: Leqembi, Kisunla, Rexulti, Adlarity, Auvelity

Primary research:

• Survey of 100 U.S. neurologists
• Survey of 30 U.S. managed care organization pharmacy and medical directors

Fingertip Formulary: Formulary coverage by Medicare Part D plans covering up to 37.5 million lives

Real-world data: U.S. pharmacy and medical claims data

Key analyses:

• Reimbursement and contracting
• Access and prescribing
• Buy & bill calculations and analysis
• Couponing and patient affordability
• Opportunities and challenges for emerging therapies