Onglyza gets 44% coverage of US commercial health plans but less than 1%of Medicare for type 2 diabetes

Recently-approved for marketing in the treatment of type 2 diabetes in the USA, Bristol-Myers Squibb/AstraZeneca's Onglyza (saxagliptin) is covered by 44% of commercial health plans but less than one percent of Medicare plans. According to the Formulary Forum report entitled Formulary Advantages in Type 2 Diabetes: Impact of Current and Future DPP-IV Inhibitors and GLP-1 Analogues on Advantaged Reimbursement Status for Key Brands, among plans that have Onglyza on formulary, the majority have placed the drug on Tier 3.

The three-tier open formulary is the most common formulary design in the USA, therefore the positioning of Onglyza as a primarily Tier 3 benefit is consistent with survey findings that show 40% of surveyed pharmacy directors say they cover emerging agents, including Onglyza which was approved for the treatment of type 2 diabetes in July, on their highest tier until they can complete an internal review.

"Large plans have most rapidly added Onglyza to their formularies but mostly as a Tier 3 benefit, likely as a default option until an internal review can be conducted and they can determine whether the drug should be upgraded to Tier 2," said Michael Malecki, product manager for Formulary Forum. "Our survey found that nearly three-quarters of surveyed pharmacy directors from large plans say they expect their managed care organization to review emerging therapies within six months of FDA approval, so we expect the story of Onglyza's coverage to evolve over the coming months," he added.

A Citigroup pharmaceutical analysts recently projected US peak sales for the drug at $1 billion a year.