Eighty Percent of Surveyed Pharmacy Directors Report that Higher Rebates and Discounts Prompted Their Managed Care Organization to Offer Preferential Reimbursement, According to a New Report from HealthLeaders-InterStudy and Fingertip Formulary
May 19, 2011 10:37 AM Eastern Daylight Time
NASHVILLE, Tenn. & GLEN ROCK, N.J.--(EON: Enhanced Online News)--HealthLeaders-InterStudy and Fingertip Formulary find that superior clinical attributes of hepatitis C therapies, such as convenience, improved compliance and improved tolerability, have little influence over reimbursement status compared to rebates and discounts. According to the recent Formulary Forum report entitled Formulary Advantages in Hepatitis C: Despite the Near Certainty of Emerging Oral Protease Inhibitors, Pharmacy Directors Remain Unsure of the Value and Reimbursement Status of Triple Therapy Protocols, most (80 percent) surveyed pharmacy directors report that higher rebates and discounts lead to preferential reimbursement from U.S. health plans.
The report finds that a greater percentage of managed care organizations receive rebates and discounts for Roche’s Pegasys (peginterferon alpha-2a) than for Merck’s PegIntron (peginterferon alpha-2b). In April 2011, the U.S. Food and Drug Administration recommended the approval of Merck’s boceprevir and Vertex Pharmaceuticals’ telaprevir for use in hepatitis C triple therapy regimens. If Roche continues to maintain Pegasys’ preferred reimbursement status, particularly as a means to encourage greater use of triple therapy protocols that include Pegasys, then telaprevir will be more successful than boceprevir.
“The higher success rates for emerging triple therapy regiments compared with conventional dual therapy regimens will result in higher treatment rates for hepatitis C,” said Leigh Compton, M.D., Ph.D., author of the report. “If Merck wants boceprevir to be considered for preferential reimbursement, they need to increase their efforts to improve the reimbursement status of PegIntron among U.S. health plans by offering more generous rebates and discounts, at least until efficacy data for boceprevir in combination with Pegasys are available.”
The new Formulary Forum report is based on a survey of 50 U.S. pharmacy directors who control formularies at national, regional and state-level managed care organizations, as well as historical formulary data from Fingertip Formulary.
About Fingertip Formulary
Fingertip Formulary (www.FingertipFormulary.com), the leading provider of access to and insight into formulary data in the United States, offers comprehensive formulary data covering commercial, Medicaid, Medicare and PBM plans, among others. Fingertip Formulary is a Decision Resources, Inc. company.
HealthLeaders-InterStudy, a Decision Resources, Inc. company, is the authoritative source for managed care data, analysis and news. For more information, please visit www.HL-ISY.com.
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