KEY THERAPEUTIC CLASSES BY NET DOLLAR IMPACT
HIV/AIDS
Cystic Fibrosis, Oral Net Dollar Impact $0.42
$33.9M
5.4%
Net Spend Trend
Total Net Spend Trend
-10.2%
Claim Volume Trend
Net Dollar Impact $0.32
17.5%
$32.5M
Net Cost Per Claim Trend
21.5%
Net Spend Trend
17.8%
Total Net Spend Trend
Claim Volume Trend
3.1%
Net Cost Per Claim Trend
Class Summary
Class Summary
HIV antiretrovirals remained the No. 1 net spend class in 2019. This class was also the No. 1 positive trend driver. With less than two years on the market, Biktarvy has quickly become the No. 1 net spend product in Medicaid. Utilization of Biktarvy drew from other Gilead products such as Genvoya, the No. 1 negative trend driver; Descovy, the No. 7 negative trend driver; products containing tenofovir disoproxil fumarate; and even Triumeq (No. 9) and Tivicay (No. 10).
This class was the No. 2 positive trend driver due to an 18% increase in utilization, moving from the No. 7 net spend class in 2018 to No. 6 in 2019.
FIGURE 33: MARKET SHARE AND NET DOLLAR IMPACT FIGURE 32: MARKET SHARE AND NET DOLLAR IMPACT Biktarvy (Oral) Tivicay (Oral) Triumeq (Oral)
Genvoya (Oral) Descovy (Oral) Other
Market Share
MARKET
Net Dollar Impact Change
4.0% 12.6%
Symdeko (Oral) Orkambi Tablet (Oral) Kalydeco Tablet (Oral) Orkambi Packet (Oral) Trikafta (Oral) Other
Biktarvy was not only the No. 1 net spend product but also the No. 1 positive trend driver. This class contained three of the Top 5 net spend products and was the No. 1 positive trend driver.
16.5%
Market Share
Net Dollar Impact Change
11.0%
10.8%
9.7%
9.5%
9.0%
0.28
$
MARKET
BRAND
Symtuza, the No. 5 positive trend driver, rose from the No. 253 net spend product in 2018 to No. 27 in 2019 despite the inclusion of a protease inhibitor instead of an integrase inhibitor.
1.19
$
8.9
%
0.14
$
55.6%
30.8%
0
-0.25
Symdeko was the No. 4 positive trend driver, advancing from the No. 23 net spend product in 2018 to No. 7 in 2019. These increases made the class the No. 2 positive trend driver in 2019.
0.13
$
0.01
$
$
52.2%
44.9%
-0.09 $-0.12 $
-0.11
$
-0.21
$
2018
11
2019
Trikafta was introduced to the market in 2019 and became the No. 76 net spend product. This pathway is similar to the other products in this class — utilization and net spend grow quickly.
20.1% 33.2%
10.9%
MARKET
CLINICAL
Dual-combination single-tablet regimens containing integrase inhibitors did not pick up significant market share, amounting to just 1% of all utilization in this class in 2019.
2019
MAGELLAN RX MEDICAID PHARMACY TREND REPORT / 2020
0
13.3% 10.7
%
17.2% 2.2
%
4.9% 2018
-0.23
$
7.7% 4.3% 2019
-0.01
$
2019
CLINICAL
Most investigational candidates in this class are not beyond phase two in clinical trials; therefore, market competition will not drive down net costs.