 SAMM --
September 2007
 In This Issue...
Introduction
Competition in the generic-heavy type 2 diabetes market is intensifying as brands struggle to
attain and hold market share. In this edition of Strategic Assessment of
Managed Markets, Decision Resources examines the relationship between a drug’s
formulary placement and level of access in each of the 50 largest US cities and ties this directly to the drug’s performance. In each city we examine the
five largest managed care organizations’ formulary tier structure and
prescribing limitations placed upon antidiabetic agents. In addition we are
introducing a truly unique and insightful examination of the prevalence of type
2 diabetes and the projected drug treatment rates for each of the 50 major
markets to identify areas of under-treatment and possible growth opportunities.
In this report
we examine the dynamic type 2 diabetes market managed care strategy within the United States among branded products. Recent safety concerns with PPAR-gamma agonist formulations
have made an early impact in market share among the top brands in the type 2
diabetes market. Actos and Avandia, two products in the middle of their life
cycle, have held the top two brand positions within this market for some time, but
increasing competition from new DPP-IV introductions Januvia and Janumet
threatens to challenge their market dominance. The DPP-IV introductions are
gaining attention as the next breakthrough in diabetes treatment and are making
progress building market share within the top 50 MSAs, especially considering
that they currently have very limited formulary access within these markets.
Fixed-dose combinations constitute the middle of the type 2 diabetes market yet
may see their overall share decline in the wake of PPAR-gamma agonist safety
concerns and the introduction of new agents into the marketplace. Byetta, an
injectable GLP-1 analogue, exhibits strong growth and the improved delivery
profile of newer formulations will also influence Byetta’s market share.
For easy
review we provide both an in-depth report that highlights the findings of our
research and three Excel-based dashboards organized for each city (MSA), health
plan, and branded drug. Each dashboard examines the dominant drivers of
performance such as formulary tier status, restrictions to access, co-pay for
generic, preferred brand and non-preferred brand. In addition, we examine the
plans spend level by generics and brand (preferred and non-preferred) and, in
the MSA dash, we provide disease prevalence numbers, drug-treated estimates,
dominant managed care organizations ranked by commercially insured Rx lives,
and the formulary status for major brands prescribed to control diabetes.
This combined
insight provides a unique examination of the type 2 diabetes drug market viewed
through the filters of formulary access and MSA prevalence to drug
treated ratio to provide actionable avenues to increase market share of
marketed drugs or to plan the launch of a novel agent into the type 2 diabetes
market.
Questions Answered In This Report:
Opportunities for overall market growth: By looking at regional epidemiology data and regional treatment
rates we identify the largest opportunity areas within the United States. What is the type 2 diabetes prevalence at the local level, and is it
driven by age, gender, race, or socioeconomic status? Which markets have the
highest treatment rates based on local prescription volumes of type 2 diabetes
drugs?
Formulary Control: Formulary
data collected for the top 5 commercial insurers among the top 50 MSAs informs
comparative analysis of how dyslipidemia brands are positioned within regional
markets. Which markets are the most restrictive in terms of plan-specific
demand controls? What percentage of beneficiaries access Avandia at tier 2
versus Actos?
Market Dynamics: Strategic
summarization and organization of key managed care data metrics facilitates
identification of markets and plans of opportunity for key brands. In which
markets should Merck contract for better formulary access? Where should Amylin
and Lilly focus for more effective pull-through?
Includes:
- Eleven key type 2 diabetes brands: Actoplus Met, Actos, Avandamet, Avandaryl, Avandia, Byetta,
Janumet, Januvia, Prandin, Starlix, Symlin
- Performance of competing generic drugs: Alpha-Glucosidase Inhibitors, Biguanides, Sulfonylureas
and other Fixed-Dose Combinations
- Top 50 MSAs: Atlanta, Austin,
Baltimore, Bergen, Boston, Charlotte, Chicago, Cincinnati, Cleveland, Columbus,
Dallas, Denver, Detroit, Fort Lauderdale, Fort Worth, Greensboro, Houston,
Indianapolis, Kansas City, Las Vegas, Los Angeles, Miami, Milwaukee,
Minneapolis, Nashville, Nassau, New Haven, New York, Newark, Norfolk, Oakland,
Orange County, Orlando, Philadelphia, Phoenix, Pittsburgh, Portland, Raleigh,
Riverside, Sacramento, Salt Lake City, San Antonio, San Diego, San Francisco,
San Jose, Seattle, St. Louis, Tampa, Washington D.C., and West Palm Beach
- Top 20 health plans and formularies: Aetna, BCBS of Florida, BCBS of Massachusetts, BCBS of
Michigan, Blue Shield of California, CareFirst, CIGNA HealthCare, Coventry
Health Care, Harvard Pilgrim Health Care, Health Care Service Corporation,
Health Net, Highmark, Horizon BCBS of New Jersey, Independence Blue Cross,
Kaiser Foundation Health Plans, Medica, The Regence Group, Tufts Associated
Health Plans, UnitedHealth Group, WellPoint
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