US surveyed PCPs and pain specialists experienced reimbursement restrictions for Janssen's Nucynta ER

The majority of US surveyed primary care physicians (PCPs) and pain specialists indicate that they have experienced reimbursement restrictions when prescribing Johnson & Johnson (NYSE: JNJ) subsidiary Janssen's Nucynta ER (tapentadol), for chronic low back pain, according to the latest findings of advisory firm Decision Resources.

Prior authorization and formulary exclusion are the most frequently reported restrictions encountered. 60% of surveyed managed care organizations’ (MCOs) pharmacy directors report Nucynta ER is listed as a pharmacy benefit on their largest commercial plans, compared with 88% of respondents indicating Purdue’s OxyContin (oxycodone HCl controlled-release) is listed as a pharmacy benefit. In contrast, only 44% of MCO pharmacy directors indicate that AstraZeneca/Pozen’s fixed-dose combination Vimovo (naproxen/esomeprazole magnesium) is listed as a pharmacy benefit, likely due to the multitude of generic equivalents available.

The new US Physician & Payer Forum report, titled Chronic Low Back Pain: Reimbursement and Uptake of Novel Agents and Tamper-Resistant Opioids Among Payers and Prescribers, also finds that some surveyed MCO pharmacy directors expect the coverage and formulary tier status of Nucynta ER to improve in their largest risk-based commercial plan in one year’s time. 28% and 36% of surveyed MCOs report that Nucynta ER is currently covered on tier 2 or tier 3 of their formularies, respectively, while 32% and 44% expect the drug to be included on either tier 2 or tier 3 in one year’s time.