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Special Report: The Pricing and Reimbursement Environment for Respiratory Disease Therapies

Decision Resources
October 1, 2011
SKU: DECR6640835

Abstract Table of Contents Related Reports

Common respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) make up a large and varied pharmaceutical market sector. These diseases also impose a significant burden on patients, providers, and payers, putting them front and center as the subjects of efforts to improve patient outcomes while containing costs to health systems. Governments and other payers are compelled to invest substantial resources in the management of these disorders. At the same time, payers continue to scrutinize the cost-to-benefit ratio of all therapeutic options very closely. The pharmaceutical industry will need to make a clear case for the role of drug therapy as a critical component in the effective management of respiratory disorders.

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Executive Summary: Strategic Considerations; Stakeholder Implications
Introduction
United States: General Environment; Healthcare Reform; Formulary Positioning; Cost-Containment Measures; Physician Survey; Asthma; COPD; Allergies
France: General Environment; Asthma; COPD; Allergies
Germany: General Environment; Asthma; COPD; Allergies
Italy: General Environment; Asthma; COPD; Allergies
Spain: General Environment; Asthma; COPD; Allergies
United Kingdom: General Environment; Asthma; COPD; Allergies
Japan: General Environment; Asthma; COPD; Allergies
Outlook and Implications for the Pharmaceutical Industry
Tables: 1. Leading Respiratory Disease Therapies—Asthma/COPD; 2. U.S. Commercial Health Plans’ Formulary Positioning of Select Respiratory Disease Therapies, by Percentage of Plans, August 2011; 3. U.S. Commercial Health Plans’ Formulary Positioning of Select Respiratory Disease Therapies, by Percentage of Covered Lives, August 2011; 4. U.S. Medicare Plans’ Formulary Positioning of Select Respiratory Disease Therapies, by Percentage of Plans, August 2011; 5. U.S. Medicare Plans’ Formulary Positioning of Select Respiratory Disease Therapies, by Percentage of Covered Lives, August 2011; 6. Percentage of U.S. Commercial Health Plans That Subject Select Respiratory Disease Therapies to Prescribing Restrictions, August 2011; 7. Percentage of U.S. Medicare Plans That Subject Select Respiratory Disease Therapies to Prescribing Restrictions, August 2011; 8. Percentage of U.S. Physicians Expecting Actions Payers Might Take in the Next Five Years to Control the Cost of Managing Common Respiratory Disorders; 9. Drug Classes and Categories Subject to Prescribing Targets in Germany, 2011
Figures: 1. Prevalent Populations of Common Respiratory Disorders in Seven Mature Markets,2010 and 2020; 2. Drug-Treatment Rates for Common Respiratory Disorders in Seven Mature Markets,2010 and 2020; 3. Global Sales of Major Categories of Respiratory Drugs, 2005-2010; 4. Health Insurance Coverage of the U.S. Population, 1999-2009; 5. U.S. Residents’ Sources of Prescription Drug Benefits, July 2010; 6. Sources of Funding for Drug Therapy to Treat Respiratory Diseases in the United States, 2010 (partial year); 7. Average Positioning of Select Respiratory Disease Therapies in the Formularies of U.S. Commercial Health Plans, August 2011; 8. Average Positioning of Select Respiratory Disease Therapies in the Formularies of U.S. Medicare Plans, August 2011; 9. U.S. Employers’ Use of Common Utilization Management Tools, 2007-2010; 10. Average Number of Patients with Select Respiratory Disorders Treated by U.S.Physician Survey Respondents in a Typical 30-Day Period, 2011; 11. Healthcare Coverage for Patients with Respiratory Disorders Treated by U.S.Physician Survey Respondents, 2011; 12. U.S. Physicians’ Views on the Impact of Out-of-Pocket Costs on Patients’ Access to Drug Therapies for Common Respiratory Disorders; 13. Respiratory Drugs Whose Out-of-Pocket Costs Are a Burden for Asthma or COPD Patients Managed by Surveyed U.S. Physicians; 14. Respiratory Drugs Whose Out-of-Pocket Costs Are a Burden for Respiratory Allergy Patients Managed by Surveyed U.S. Physicians; 15. Estimated Percentage of U.S. Patients with Common Respiratory Disorders Who Fail to Fill Prescriptions, Skip Doses, or Discontinue Therapy Because of the Cost; 16. U.S. Physicians’ Views on the Impact of Health Plan Coverage Restrictions on Patients’ Access to Drug Therapy for Common Respiratory Disorders; 17. U.S. Physicians’ Ratings of Patients’ Struggles to Afford Drug Therapy for Asthma or COPD, by Health Care Coverage Type; 18. Percentage of U.S. Physicians Who Receive Requests from Payers or Patients to Prescribe Generic Forms of Inhaled Drugs; 19. Percentage of U.S. Patients Receiving Generic Drugs as First-Line Therapy for Common Respiratory Disorders; 20. U.S. Physicians’ Willingness to Prescribe Generic Drug Therapies for Common Respiratory Disorders; 21. U.S. Physicians’ Reservations About Use of Generic Drugs for Common Respiratory Disorders; 22. U.S. Physicians’ Expectations Regarding the Likelihood That Payers Will Take Action in the Next Five Years to Control the Cost of Managing Respiratory Disorders; 23. U.S. Employers’ Use of Common Utilization Management Tools to Control Spending on Asthma Treatment, 2010; 24. U.S. Physicians’ Views on How the Pharmaceutical Industry Could Improve Access to Respiratory Drugs

Special Report: The Pricing and Reimbursement Environment for Respiratory Disease Therapies

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