The Impact of Payer Policy on Uptake of GLP-1 Receptor Agonists and Insulins for Type 2 Diabetes | Physician & Payer Forum | US | 2015

A Survey of Primary Care Physicians, Endocrinologists, and Managed Care Organization Pharmacy and Medical Directors

Type 2 diabetes is a complex metabolic disorder characterized by a declining ability to produce or utilize insulin. The chronic and progressive nature of the disease, as well as its complications and common comorbidities, often leads to patients requiring multiple medications. The type 2 diabetes market represents a crowded treatment landscape. Despite this crowded landscape, patients typically follow a relatively well-defined treatment progression, beginning with oral therapies before adding injectable agents such as the glucagon-like peptide-1 (GLP-1) receptor agonists and insulins as the disease progresses. However, these injectable therapies are among the most efficacious on the market, and with growing individualization of patient therapy, their use is becoming increasingly prominent in the early lines of therapy. Over the next few years, new GLP-1 receptor agonists and rapid- and long-acting insulin analogues are expected to launch. As these new agents compete for positioning and uptake, physicians and managed care organizations (MCOs) must consider how best to incorporate them into their respective treatment and reimbursement strategies as they seek to optimize value for money.

Drawing on insight from a survey of 142 physicians and 30 MCO pharmacy or medical directors (PDs or MDs), this report examines the dynamics that limit or promote—now and in the near future—market access for the new market entrants and emerging therapies for type 2 diabetes.