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Multiple Sclerosis | Access and Reimbursement | US | 2022

The multiple sclerosis (MS) therapy market continues to evolve, with each new FDA-approved disease-modifying therapy (DMT) further expanding treatment choices. The newest entrants (e.g., Zeposia, Kesimpta, Ponvory) and nearest-to-launch emerging therapies (e.g., ublituximab, GA Depot) have entered / will enter established drug classes, while novel Bruton’s tyrosine kinase (BTK) inhibitors will establish a new but soon-to-be crowded class; in each case, demonstrating meaningful differentiation for payers and prescribers will be critical. Meanwhile, the 2020 debut of generics competition for former market-leader Tecfidera—and the anticipated launch of several other oral generics in the coming year—introduces a new variable in formulary placement and physician choice, especially in the relapsing MS space. For developers bringing innovative or next-generation DMTs to market, understanding the current and future influence of clinical and economic metrics 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 do DMT cost and payer restrictions influence clinical decision-making in MS today?
  • How receptive are surveyed neurologists and payers to key novel and next-in-class agents?
  • How is generics competition for dimethyl fumarate affecting coverage and prescribing in the MS market?
  • 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?

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, Ponvory, ublituximab.

Content highlights:

  • Reimbursement and contracting.
  • Access and prescribing.
  • Opportunities and challenges for emerging therapies.
  • Disease-specific special topics.

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