Hemophilia treatment is gradually consuming more U.S. payer budget dollars. The increasing cost of factor concentrate and the growing preference for prophylaxis treatment are key factors driving these costs upward. Despite hemophilia patient advocacy groups strongly pushing for coverage of all brands, formulary exclusions are starting to appear. In some states, Medicaid is doing more to control the cost of factor concentrate use (for example, by introducing preferred/nonpreferred formulary tiers). Additionally, hemophilia payers tend to focus on direct cost. Given that replacement of a joint as a result of hemophilic arthropathy will not become a reality for another 20 years, payers remain focused on what will happen over the next 18-24 months.
Geography: United States
Primary Research: Survey of 100 U.S. hematologists Survey of 30 U.S. managed care organization (MCO) pharmacy and medical directors (PDs/MDs)
Key Drugs Covered: Hemlibra, Advate, Adynovate, Afstyla, Alprolix, BeneFIX, Eloctate, FEIBA, Hemlibra, Idelvion, Jivi, Kogenate, Kovaltry, Novoeight, NovoSeven, Nuwiq, Xyntha
U.S. Access & Reimbursement provides in-depth insight on the impact of payer policy on prescribing behavior so that clients can build their market access strategy and optimize their brand positioning. This analysis of primary market research with physician specialists and U.S. payers helps clients stay up-to-date on restriction policies, gauge payer and prescriber attitudes toward specific therapies, identify opportunities where brands can capture patient share through market access, and maximize opportunities for emerging therapies by learning how previous brands gained favorable reimbursement or why they stumbled.