Multiple Sclerosis | Access and Reimbursement | US | 2021
The multiple sclerosis (MS) therapy market continues to evolve with each new FDA-approved disease-modifying therapy (DMT) further expanding treatment choice. The newest entrants (e.g., Kesimpta, Vumerity, Zeposia) and nearest-to-launch emerging therapies (e.g., Ponvory, ublituximab, GA Depot) are entering established drug classes, and although many offer a unique advantage over first-in-class options, they may struggle unless developers demonstrate meaningful differentiation for payers and prescribers. Meanwhile, the recent debut of generics competition for former market-leader Tecfidera—and the anticipated launch of several other oral generics in the coming years—will exert a new pressure on formulary placement and physician choice, especially in the relapsing MS space. For developers bringing novel or next-generation DMTs to market, understanding the current and future influence of clinical metrics and value-for-dollar on access and prescribing will be key.
Questions Answered
- What is the current formulary status of MS DMTs, and what approaches do payers use to manage utilization and costs?
- How will MCOs assess value and formulary placement for emerging DMTs? How will new agents be prescribed in an increasingly crowded and high-cost MS market?
- How will the clinical differentiators of some next-in-class agents (e.g., Kesimpta, Zeposia, Ponvory) be viewed from a payer and physician perspective?
- How will generic competition for Tecfidera affect coverage and prescribing in the MS market?
Product Description
U.S. Access & Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of U.S. payer policy on physician prescribing behavior in the market access environment, including up-to-date analysis of drug coverage and restriction policies and payer and prescriber perspectives on key marketed drugs and receptivity to emerging therapies.
Markets covered: United States
Primary research:
- Survey of 100 U.S. neurologists.
- Survey of 30 U.S. managed care organization (MCO) pharmacy and medical directors (PDs/MDs).
Key companies: Roche, Merck, Novartis, Receptos, Celgene, AB Science, Viatris / Mapi Pharma, TG Therapeutics, Janssen, Sanofi, EMD Serono
Key drugs: Aubagio, Bafiertam, Tecfidera / dimethyl fumarate, Copaxone / glatiramer acetate, Gilenya, interferons, Kesimpta, Lemtrada, Mavenclad, Mayzent, Ocrevus, Tysabri, Vumerity, Zeposia, BTK inhibitors, GA Depot, masitinib, Ponvory, ublituximab
Content highlights:
- Reimbursement and contracting.
- Access and prescribing.
- Opportunities and challenges for emerging therapies.
- Disease-specific special topics.
