NASHVILLE, Tenn. and GLEN ROCK, N.J., Dec. 15 HealthLeaders-InterStudy and Fingertip Formulary find that 70 percent of surveyed pharmacy directors expect to cover Pfizer's tanezumab if it is approved for the treatment of chronic pain. Tanezumab, which is expected to be the first biologic approved for chronic pain and is administered intravenously under medical supervision, will likely be covered as a medical benefit rather than a pharmacy benefit according to surveyed pharmacy directors. According to the new Formulary Forum report entitled Formulary Advantages in Chronic Pain Therapies: How Will Price Impact the Coverage of Expensive Abuse-Deterrent Opioids and Biologics?, nearly half of surveyed pharmacy directors (48%) say they expect to cover tanezumab as both a medical and pharmacy benefit.
Survey findings indicate that as the price of tanezumab drops, more pharmacy directors are willing to cover the drug for patients with back pain. Moreover, pharmacy directors indicate that at lower prices they are willing to cover tanezumab for more back pain patients, regardless of whether the patient is eligible for surgery.
"Our survey finds that as the price of tanezumab decreases more pharmacy directors say they will not only cover the drug, but they will cover it for a larger patient group. However, they still require patients to fail multiple lines of pharmacotherapy before they will reimburse the drug," said Analyst Cindy Fung, Ph.D. "Survey findings also indicate that there's a limit to the number of plans that will cover tanezumab. Even at the lowest price surveyed, 15 percent of surveyed pharmacy directors say they will exclude the drug from their formularies."
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.
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