Osteoporosis | Access and Reimbursement | US | 2017

Introduction: This research explores the reimbursement and utilization landscape for anti-osteoporotic drugs. The osteoporosis market is characterized by the availability of low-cost generic oral bisphosphonates that are effective and dominate the earlier lines of osteoporosis treatment. More costly branded drugs, including Prolia (Amgen’s denosumab), Forteo (Eli Lilly’s teriparatide), and Tymlos (Radius Health’s abaloparatide SC), are injectable and have been shown to have efficacy superior to the bisphosphonates. Branded injectable therapies typically feature in second or later lines of therapy, reserved for the most severe cases of osteoporosis. With generics giving payers leverage to control drug prices in osteoporosis, this report’s data-driven analysis helps developers of novel anti-osteoporotic drugs understand the influence of clinical and economical factors affecting market access and medical practice in the United States.

Questions Answered in This Report:

• Which anti-osteoporotic drugs commonly receive favorable formulary placement, and what approaches do payers employ to manage utilization and costs?
• How are MCOs performing value assessments for anti-osteoporotic drugs, and what are the preferred pharmacoeconomic models?
• How successful is Radius Health in gaining market access for its recently launched parathyroid hormone analogue Tymlos?
• How will emerging anti-osteoporotic drugs be reimbursed and prescribed in a market dominated by generic oral bisphosphonates?

Scope:

• Markets covered: United States.
• Methodology: Surveys of 50 PCPs, 32 endocrinologists, and 22 rheumatolgists as well as 30 managed care organization (MCO) officials in September 2017.
• Indication coverage: Osteoporosis.
• Key Drugs covered: Prolia, Forteo, Tymlos, alendronate (Fosamax), risedronate (Actonel), zoledronate (Reclast), ibandronate (Boniva).
• Key companies mentioned: Amgen, Eli Lilly, Radius Health, Merck, Novartis, Roche/GlaxoSmithKline.