Formulary Advantages in Atrial Fibrillation: How Will MCO Size Affect the Design of Factor Xa Formularies?

In the coming years, atrial fibrillation (AF) patients will increasingly have more choice for anticoagulation therapy. Although Boehringer Ingelheim’s Pradaxa (dabigatran etexilate) and emerging factor Xa inhibitors will offer clinical advantages over warfarin, their high prices will likely be the greatest obstacle to patient access. Using tiering and restrictions data from Fingertip Formulary and insight from 50 pharmacy directors, we discuss the key trends in reimbursement of AF therapies, the drivers of these trends, and how stakeholders can capitalize on future shifts in coverage to beat the competition.