Spotlight on MMIT Solutions Actionable understandings from MMIT’s data and applications May 27, 2019 Study Shows Biologics, Biosimilars Gained Rapid Uptake in 2018 3 Chart: Impact of Biosimilars Almost 5.8 billion prescriptions were dispensed in the United States in 2018, an increase of 2.7% over the previous year, according to the IQVIA Integrated Delivery Networks’ Institute for Human Data Science’s report Medicine Use and Spending in the 4 Impact Extends to PBM, Specialty Pharmacy Sectors U.S.: A Review of 2018 and Outlook to 2023. “More Americans took more medicines than ever before in 2018,” stated Murray Aitken, executive direc- Payers Say They Are Likely to Cover 5 Eylea and Lucentis at Parity in tor of the institute, during a May 6 press call. Diabetic Retinopathy Retail and mail pharmacies dispensed 127 million specialty prescriptions 6 Reality Check on Low Testosterone last year, an increase of 15 million since 2014. In 2018, for the second year in a row, specialty prescription volume grew more than 5% although the med- icines accounted for only 2.2% of prescriptions overall. With an increase in the availability of oral and self-injected specialty therapies, these drugs “are increasingly dispensed through retail pharmacies,” said Aitken. Fifty-five percent of oncolytics were dispensed through retail, 75% of autoimmune therapies, 78% of HIV drugs, 80% of viral hepatitis treatments and 91% of multiple sclerosis medicines. continued on p. 3 Spotlight on MMIT Team: Evan Curcic Evan Curcic is a client success manager at MMIT, developing market ac- cess solutions for our small-to-medium size client base. He works to onboard new clients to MMIT’s platforms and helps current clients get the most value out of MMIT’s solutions during all phases of their brand’s life cycle. Q: How did you join the company? A: When I first joined MMIT six years ago, I had a background primar- ily in software development and client service. Health care was just not an industry that I’d been exposed to yet, but I was a huge fan of B2B software as a service and working directly with clients. I had a friend who worked for MMIT’s top recruiting partner at the time who got me an interview and the rest is history. I’ve really enjoyed getting experience in the health care and market access industry, and I really love working in this space now. Q: What’s your day to day like? A: My day-to-day consists of partnership kickoff calls with new clients, therapeutic area briefs, data and lives methodology trainings, promotional project planning, consultative reporting engagement and datafeed struc- © Managed Markets Insight & Technology, LLC | 1 Spotlight on MMIT Solutions May 27, 2019 ture and bridging overviews. My main goal is to help analogs in that therapeutic area have gone through. align our clients’ business objectives with the use of What challenges has everyone else seen? What we’ve our solutions. I want them to feel confident and that seen over the past few years is that things have pro- they’re getting the utmost value from our engagements gressively gotten a lot more restrictive. With that with them so they can do their jobs even better and shift to higher utilization management out of launch, be able to answer any of their market access business sometimes clients have to wait longer for payers and questions at any time. PBMs to make decisions. That’s where I believe MMIT Q: What are some of the challenges of your shines, because that’s where our PAR (prior authoriza- role? A: Our job is not done just because we’ve sold a client our solutions. You have to give them a really positive experience off the bat, build trust, make sure they’re being heard and their needs are being met. Each account I work with has a different therapeu- tic area and slightly different goals they’re trying to achieve, and I’m also working with a lot clients pri- marily in the middle of launch, so one of my biggest challenges is making sure that I’m providing enough time for all of my clients and showing them all the same level of TLC. Q: What are some of the larger projects Evan Curcic you’re working on? tion and restriction) data can be very valuable. Clients A: Like most companies, our large clients get a are saying, ‘Hey, what are these prior authorization or certain level of service and engagement, and rightful- step therapy challenges that other brands have faced, ly so. I think what sets MMIT apart from our direct and are we going to see something similar?” competitors in this niche is that for the past few years, we’ve really focused on trying to provide that same lev- We’re even seeing some drastic shifts in restric- el of service and value to our small- and medium-sized tiveness year over year. Let’s say I’m launching a new clients as well. Just because a client may not have a product in a therapeutic area, and let’s say some of massive contract with us or a huge spending budget the big-name blockbuster drugs in that class were doesn’t mean that they shouldn’t get the same level of launched just four or five years ago. The restrictive service and attention that some other companies might climate of launch has shifted so quickly year-over-year, only invest in their largest customers. I’ve directly had that even though those drugs are successful products, a hand in improving this process over the last few years you may want to look at something more recent to by taking the experience I’ve gained working with our compensate for some of those drastic yearly access larger clients and bringing that to our small-to-me- climate changes. dium segment with great support, collaboration and Q: Any buzzworthy therapeutic areas to guidance from MMIT leadership. watch out for? Q: What market access trends should cli- A: What we’re seeing happening with rare orphan ents be looking out for? disease drugs is really interesting. I’m starting to work A: When you’re talking about launching products, with more manufacturers who are releasing these types a lot of my clients are doing a ton of market research. of products. Unlike some other areas, payers and PBMs Let’s say they’re in pre-launch mode, and they’re trying are making faster decisions there, so it’s interesting to get a good understanding of what some of the other to watch as spending and FDA approval for those © Managed Markets Insight & Technology, LLC. Contact [email protected]. | 2 Spotlight on MMIT Solutions May 27, 2019 products shifts. For certain rare disease drugs that are Biosimilar Use Rose in 2018 solving a unique problem for a small population, we’re continued from p. 1 seeing them get coverage a little bit more quickly than Researchers found that there has been rapid they did five years ago, and that’s contrary to the level uptake of the programmed cell death-1 (PD-1) and of restrictiveness we’re seeing in some other therapeu- programmed cell death ligand-1 (PD-L1) inhibitors. tic areas of access. In 2014, following the FDA approval of Merck & Co., Q: What’s your favorite part of your job? Inc.’s Keytruda (pembrolizumab) in September, there A: Up to this point, I’ve worked with around 70 were 2,403 people treated with an immuno- oncology different pharma manufacturers. And through part- checkpoint inhibitor. That number rose to 212,473 in nering with those clients, I’ve learned a ton in terms 2018, with six products on the market boasting numer- of what pharma is doing and focused on in terms of ous indications. access at an aggregate level. I get a lot of satisfaction The use of biosimilars — which the institute defines from providing insights to my clients in terms of how on a broader basis than only those therapies approved I’ve seen other folks do it (anonymously of course), and through the 351(k) pathway — “in terms of volume is give them some options that let them pick and choose still modest,” said Aitken, with these drugs represent- how they want to approach things using our solutions. ing less than 2% of the total biologics market in 2018 I love being able to bring insight into our discussions (see chart below). But in areas where a biosimilar is that they find valuable and want to act on. available, “there is reasonably rapid uptake.” The report Q: What do you like to do outside of work? showed that by fourth-quarter 2018, in areas where bi- osimilars are accessible, these drugs accounted for 30% A: I love spending time with my family, especially of the total volume, up from 22.5% the prior year. In my wife and 2-year-old daughter. I’m also a huge live 2018, total spending on biologics increased 9.5%, with music fan and music nerd. I love sports and the out- 13% of that spending subject to biosimilar competition. doors as well. Any activity combining those things, I’m all about it. G To download the report, visit www.iqvia.com. G by Carina Belles by Angela Maas Biologics Net Spending US$Bn Original Volume Share of Impact of Biosimilars Standard Units Since Biosimilar Introduction Original Volume Share of Biologics Net Spending US$Bn Standard Units Since Biosimilar Introduction 125.5 100% 1.9 114.6 90% 0.9 103.6 14.0 93.0 0.3 10.5 3.7 80% 0.3 2.9 83.6 1.7 8.2 0.2 16.6 70% 1.7 18.2 105.9 60% 17.6 95.0 83.8 50% 72.8 64.1 40% 2014 2015 2016 2017 2018 0 6 12 18 24 30 36 42 48 Months Since Biosimilar Introduction Other Biologics Originals Pre-Biosimilar Neupogen Remicade Lantus Originals Post-Biosimilar Biosimilars Humalog Epogen Neulasta Chart Notes: Biologics are defined by IQVIA as clearly identifiable molecules of biologic origin, including but not limited to products created with recombinant DNA technology and without necessarily adhering to classifications by regulatory bodies, which are sometimes inconsistent with this approach.