Formulary Advantages in Asthma and COPD Therapies: Formulary Advantages in Asthma and COPD Therapies – Abstract

The market for asthma and chronic obstructive pulmonary disease (COPD) has grown notably in recent years because of increasing prevalence and diagnosis rates for both conditions as well as the greater use of higher-cost combination therapies. Blockbuster drugs like GlaxoSmithKline's Advair (salmeterol + fluticasone propionate), Boehringer Ingelheim/Pfizer's Spiriva (tiotropium), and Merck's Singulair (montelukast) lead the $13.7 billion U.S. asthma and COPD market, with numerous other brands vying for share among the various classes. Tiering data from Fingertip Formulary show that commercial and Medicare plans offer advantaged tier coverage (Tier 1 or 2 placement) to a few number of therapies, and survey responses from pharmacy directors suggest that these decisions are based on clinical advantage over other therapies or lower prices. In some cases, surveyed plans are exclusively covering a single short-acting beta2 agonist in exchange for richer reimbursements. Between 2010 and 2019, the overall size of the inhaler market for asthma and COPD will increase to an estimated $18.3 billion with the arrival of newer combination therapies such as long-acting beta2 agonist/long-acting muscarinic antagonist drugs. Therapies expected to launch over the next several years will face a crowded market and the desire by plans to limit cost increases for asthma and COPD therapies. Because of the arrival of newer therapies as well as generic versions of popular current drugs, marketers of branded asthma and COPD therapies must think creatively to ensure advantaged tier formulary access to their drugs over the next several years. Using tiering and restrictions data from Fingertip Formulary, as well as insight from 50 pharmacy directors, this report determines the key trends in reimbursement of therapies for psychiatric disorders, drivers of these trends, and how stakeholders can capitalize on future shifts in coverage to steal share from the competition.