Migraine | Access & Reimbursement | US | Acute Migraine
2020 will be a turning point for the U.S. acute migraine market. Three novel therapies—Allergan’s Ubrelvy, Eli Lilly’s Reyvow, and Biohaven’s Nurtec ODT—entered the market in rapid succession, becoming the first novel, migraine-specific therapies to be approved in the acute segment in nearly two decades. Meanwhile a range of additional acute products are advancing through late-phase development. This report assesses how U.S. physicians and payers will react to new, premium-priced brands entering a mostly generic market, and how payer policies will affect physicians’ adoption.
QUESTIONS ANSWERED
- What formulary coverage do current acute migraine SoC treatments and brand-only products receive on commercial insurance plans today? What approaches do payers use to manage utilization / costs of these drugs?
- Given the market entry of novel therapies, what strategies will payers use to control rising costs in acute migraine? How will these restrictions impact neurologists’ prescribing practices?
- What points of clinical differentiation are/will be most compelling to neurologists and most convincing to payers?
- What discounts will payers expect to negotiate? What pharmacoeconomic data and contracting terms will be most influential in driving coverage decisions?
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.
Geography
United States.
Primary Research
Survey of 100 U.S. physicians (including 50 neurologists and 50 PCPs).
Survey of 31 U.S. managed care organization (MCO) pharmacy directors and medical directors (PDs/MDs).
Fingertip Formulary
Formulary coverage and restrictions data for acute migraine therapies by commercial plans covering approximately 168 million lives nationally.
Key Drugs Covered
Reyvow (lasmiditan), Ubrelvy (ubrogepant), Nurtec ODT (rimegepant), Elyxyb, AXS-07, Rizaport, Qtrypta, INP104, STS101, zavegepant (vazegepant), current SoC treatments.
Content Highlights
- Reimbursement and contracting.
- Access and prescribing.
- Adoption of Reyvow, Ubrelvy, and Nurtec ODT.
- Opportunities and challenges for emerging therapies.
