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Approval for One Neuropathic Pain Indication is Sufficient to Support Physician Prescribing and Payer Reimbursement Across Multiple Neuropathic Pain Populations
Date:5/28/2013

BURLINGTON, Mass., May 28, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that expanded labeling for additional neuropathic pain (NP) populations and/or broader NP labeling (peripheral NP) will not ensure increased physician prescribing or improved formulary coverage. Instead, survey findings reveal that primary care physicians, pain specialists and neurologists are comfortable prescribing NP therapies to an array of NP populations for which the agents are not specifically labeled, and the majority of surveyed managed care organization (MCO) directors will reimburse these therapies for any form of NP, at the physician's discretion.

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"Most surveyed payers recognize the difficulty in treating NP and agree that reimbursement for NP will be less restrictive than reimbursement for other forms of chronic pain," said Decision Resources Principal Business Insights Analyst Andrea Buurma . "However, newer agents like Depomed's Gralise and XenoPort's Horizant face more restrictive coverage on surveyed payers' commercial plans and Medicare prescription drug plans, likely because these agents' parent molecule, gabapentin, is available generically and has widespread, favorable formulary coverage."

The U.S. Physician & Payer Forum report entitled Neuropathic Pain: U.S. Payer and Prescriber Attitudes Toward Recently Approved and Emerging Therapies—Implications for Market Access finds that safety and/or tolerability advantages could positively influence formulary decisions owing to subsequent improvements in patient quality of life, thus offsetting downstream he
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SOURCE Decision Resources
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