Drug Most Likely to Be Covered as a Tier 3 Benefit, But Internal Review Likely Within Six Months, According to a New Report from HealthLeaders-InterStudy and Fingertip Formulary

October 13, 2009-Nashville, Tenn. and Glen Rock, N.J. – HealthLeaders-InterStudy and Fingertip Formulary find that Bristol-Myers Squibb/AstraZeneca’s Onglyza is covered by 44 percent of commercial health plans but less than one percent of Medicare plans. According to the Formulary Forum report entitled Formulary Advantages in Type 2 Diabetes: Impact of Current and Future DPP-IV Inhibitors and GLP-1 Analogues on Advantaged Reimbursement Status for Key Brands, among plans that have Onglyza on formulary, the majority have placed the drug on Tier 3.

The three-tier open formulary is the most common formulary design in the U.S., therefore the positioning of Onglyza as a primarily Tier 3 benefit is consistent with survey findings that show 40 percent of surveyed pharmacy directors say they cover emerging agents, including Onglyza which was approved for the treatment of Type 2 diabetes in July, on their highest tier until they can complete an internal review.

“Large plans have most rapidly added Onglyza to their formularies but mostly as a Tier 3 benefit, likely as a default option until an internal review can be conducted and they can determine whether the drug should be upgraded to Tier 2,” said Michael Malecki, Ph.D., product manager for Formulary Forum. “Our survey found that nearly three-quarters of surveyed pharmacy directors from large plans say they expect their managed care organization to review emerging therapies within six months of FDA approval, so we expect the story of Onglyza’s coverage to evolve over the coming months.”

About the Report
Formulary Advantages in Type 2 Diabetes: Impact of Current and Future DPP-IV Inhibitors and GLP-1 Analogues on Advantaged Reimbursement Status for Key Brands is based on a survey of 50 pharmacy directors who control national, regional and state-level managed care organizations. Answers were segmented by type of plan to illustrate variances in strategy by size of plan.

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.

About HealthLeaders-InterStudy
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.

About Decision Resources, Inc.
Decision Resources, Inc. is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources, Inc. at www.DecisionResourcesInc.com.

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