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This is the first in a series of ongoing reports that will analyze various important aspects of the managed care marketplace. Because of the growing significance of managed care, the formulary access for brand products is an extremely important determinant in market potential and ultimately in sales. We will utilize the proprietary Fingertip Formulary® database, which is the largest aggregation of formulary data available, and the Fingertip Formulary Analytics™ platform in order to research and highlight key formulary status trends in the pharmaceutical industry. Fingertip Formulary Analytics is a real-time analytic platform that provides market data and insight into formulary access throughout the United States.
Each issue of Fingertip Formulary Insights will delve into various aspects of managed care formulary trends. As always, we welcome your feedback. We hope you find this report informative and we welcome your suggestions for future topics.
Printable version (PDF 332KB)
Archives
December 2007: Lack of Impact from Two Key Generics in the Anti-depressant Formulary Market
October 2007: Formulary Position Differences between Commercial and Medicare Plans
September 2007: Impact of Patent Loss for Zocor on the Statin Marketplace
Featured article: Impact of Patent Loss for Zocor on the Statin Marketplace
Executive Summary
Because Zocor lost its patent in June 2006, we evaluated the impact of this change to the overall statin marketplace in order to gain insights into the effects of a major product becoming available in generic form. We analyzed the formulary status of the statin drug class, which accounted for over $12 billion in U.S. sales in 2006. In particular, we wanted to explore if remaining branded drugs in the statin class would have higher rates of formulary management restrictions, such as prior authorization or step therapy, or if the availability of generic simvastatin would lead to fewer plans willing to reimburse remaining brand products at tier 2.
Methods
We utilized the Fingertip Formulary Analytics platform to understand the formulary status of key products in the statin class commencing in June 2006 through August 2007. We reviewed trend rates during this time period relating to formulary coverage status, managed care restrictions. We further evaluated trends by analyzing various formulary plan design types.
Findings
While Vytorin and Lipitor were the leaders in tier 1/tier 2 availability in both the Medicare and commercial markets (as measured by percentage of covered lives), there were key differences in formulary status and movements in these two markets.
Commercial Market - In the commercial market, Vytorin has consistently been the leader in tier 1 and 2 availability in 2007. In mid 2006, Lipitor had been the leader, but over the prior year, has lost approximately 10% in absolute terms of tier 1/tier 2 coverage. Meanwhile, the availability of Crestor on tier 1 and 2 increased significantly (approximately 20% in absolute terms) in this segment over the past year.
Medicare Market - In the Medicare market, Vytorin took over the top spot from Lipitor (in terms of tier 1 and 2 availability) in July 2007 by a narrow margin. In addition, Crestor and Advicor increased their tier 1 and 2 availability significantly over the past year, while Zocor, as expected, was the primary loser in tier 1 and 2 availability.