{"id":405291,"date":"2019-09-20T00:00:00","date_gmt":"2019-09-20T00:00:00","guid":{"rendered":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acrecg0023-2019-biopharma-multiple-sclerosis-access-and-reimbursement-us-2017\/"},"modified":"2026-03-31T10:46:20","modified_gmt":"2026-03-31T10:46:20","slug":"acrecg0023-2019-biopharma-multiple-sclerosis-access-and-reimbursement-us-2017","status":"publish","type":"report","link":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acrecg0023-2019-biopharma-multiple-sclerosis-access-and-reimbursement-us-2017\/","title":{"rendered":"Multiple Sclerosis | Access and Reimbursement | US | 2017`"},"content":{"rendered":"<p>The dynamic multiple sclerosis (MS) market in the United States features more than a dozen high-cost branded (and one generic) disease-modifying therapies (<abbr title=\"disease-modifying therapy\">DMT<\/abbr>s) and an active pipeline. As the\u00a0market continues to evolve, a shift towards greater emphasis on value assessment is coming;\u00a0recent entrant Ocrevus offers a strong clinical profile at a compelling price and as generic versions of entrenched <abbr title=\"disease-modifying therapy\">DMT<\/abbr>s for relapsing forms of <abbr title=\"multiple sclerosis\">MS<\/abbr> (Teva\u2019s Copaxone 40 mg <abbr title=\"three times weekly\">3TW<\/abbr>, oral agents) will launch over the next few years. As\u00a0these forces give\u00a0payers new leverage to control surging drug costs in <abbr title=\"multiple sclerosis\">MS<\/abbr>, understanding the influence of clinical metrics and value-for-dollar on market access and medical practice\u2014as well as the intersection of these forces and stakeholders\u2014is\u00a0key for developers of novel or next-generation <abbr title=\"disease-modifying therapy\">DMT<\/abbr>s. <i>Multiple Sclerosis | Access &#038; Reimbursement | <abbr title=\"Usher syndrome\">US<\/abbr><\/i> provides in-depth insight regarding the current and future impact of payer policy on physician prescribing behavior and <abbr title=\"disease-modifying therapy\">DMT<\/abbr> usage patterns.<\/p>\n<p>Questions Answered in this Report:<\/p>\n<ul>\n<li>With high list prices and expanding\u00a0treatment choice, MS DMTs are frequently subject to reimbursement restrictions and utilization controls. <strong>Which MS DMTs receive favorable formulary placement, and what approaches do payers employ to manage utilization and costs? How restrictive do prescribers perceive these controls to be? How do utilization controls impact prescribing and DMT selection?<\/strong><\/li>\n<li>As DMT costs rise, payers will increasingly focus on value assessment and pharmacoeconomic analysis in formulary decision-making. <strong>How are MCOs performing value assessments for MS DMTs, and what are the preferred pharmacoeconomic models? How do MCOs plan to respond to ICER\u2019s report on comparative cost-effectiveness of MS DMTs?<\/strong><\/li>\n<li>The recent and anticipated launches of generic versions of entrenched DMTs\u00a0in the United States in the coming years could alter DMT reimbursement. <strong>What has been the impact of Momenta\/Sandoz\u2019s Glatopa on MS reimbursement dynamics, and how will the emergence of future generic versions of glatiramer acetate\u00a0impact formulary and prescribing decisions? How will generic oral DMTs fit into neurologists\u2019 prescribing patterns and how do MCOs plan to manage utilization of these agents compared with their branded counterparts?<\/strong><\/li>\n<li>Emerging MS DMTs that are able to meaningfully differentiate from current DMTs on clinical or cost factors will be most likely to obtain favorable market access\/reimbursement terms from MCOs. <strong>How will new brands be reimbursed and prescribed in an increasingly crowded market? What improvements do neurologists and MCOs desire from emerging therapies?<\/strong><\/li>\n<\/ul>\n<p>Scope:<\/p>\n<p><strong>Markets covered:<\/strong> United States.<\/p>\n<p><strong>Methodology:<\/strong> Surveys of 100 neurologists and 30 managed care company officials, including 15 pharmacy directors and 15 medical directors, in February 2017.<\/p>\n<p><strong>Indication coverage:<\/strong> Multiple sclerosis.<\/p>\n<p><strong>Key drugs covered:\u00a0<\/strong>Aubagio, Avonex, Betaseron, Copaxone, Extavia, Gilenya, Glatopa, Lemtrada, Plegridy, Tecfidera, Tysabri, Zinbryta, Ocrevus, ozanimod, siponimod<\/p>\n<p><strong>Key companies mentioned:<\/strong> AbbVie, Bayer HealthCare, Biogen, Celgene, EMD Serono, Novartis, Pfizer, Roche\/Genentech, Sanofi\/Genzyme, Teva<\/p>\n","protected":false},"template":"","class_list":["post-405291","report","type-report","status-publish","hentry","report-gateway-biopharma","biopharma-therapy-areas-multiple-sclerosis","biopharma-geography-us","biopharma-date-931"],"acf":[],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/405291","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report"}],"about":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/types\/report"}],"version-history":[{"count":2,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/405291\/revisions"}],"predecessor-version":[{"id":576605,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/405291\/revisions\/576605"}],"wp:attachment":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/media?parent=405291"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}