Current Market Access to Schizophrenia Medications

The FDA in September approved long-acting atypical antipsychotic Invega Hafyera (6-month paliperidone palmitate) from Janssen Pharmaceuticals, Inc., a Johnson & Johnson unit, for the treatment of schizophrenia in adults. The drug is the first twice-yearly injectable approved to treat the disease. For Janssen's extended release Invega tablet — first approved in 2006 — more than 80% of commercial covered lives are under the preferred tier/preferred with prior authorization or step therapy and covered tier/covered with PA/ST. Two other long-acting injectable forms of the drug, Invega Sustenna (63% covered or better) and Invega Trinza (48% covered or better) are also on the market. For this indication that has more than 20 agents, coverage is primarily under the pharmacy benefit, with medical benefit coverage available for limited medications.

 

NOTES: Under the pharmacy benefit, the total covered lives under commercial, health exchange, Medicare and Medicaid formularies are 169.6 million, 11.6 million, 48.0 million and 71.8 million, respectively. Under the medical benefit, the total covered lives under commercial, health exchange, Medicare and Medicaid formularies are 168.0 million, 11.6 million, 49.6 million and 71.8 million, respectively.

SOURCE: Managed Markets Insight & Technology, LLC database as of September 2021.

 

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