Table 1.

Detailed Prioritization Matrix and Prioritized Treatment Areas

Therapeutic Area (Drug)	US Prevalence	Coveragea (% Plans)	Coverage	Cost Evolutionb	Types of Therapyc	Number of Products Available	Benefit to Patientsd	Payer Perception	Monthly WAC ($)e	Durationf	Opt-in Requiredg
Obesity (Saxenda)	35%1	16%	Not covered	2.19%	Oral, injectable	3–5 products	Large Improvement	Lifestyle indication	1367.00	Chronic	X
Daytime sleepiness (Provigil)	23%65	47%	Generally covered with restrictions	5.00%	Oral	5–7 products	Large Improvement	Lifestyle indication	1563.00	Episodic
Smoking cessation (Chantix)	14%93	45%	Generally covered with restrictions	10.02%	Oral, injectable	3–5 products	Minor / No improvement	Lifestyle indication	673.90	Short course	X
Migraine (Aimovig)	17%92	58%	Generally covered with restrictions	22.48%	Oral, injectable	>10 products	Minor / No improvement	Lifestyle indication	682.10	Chronic
Fibromyalgia (Lyrica)	4%94	59%	Covered	9.03%	Oral	3–5 products	Mild improvement	Lifestyle indication	694.50	Chronic

Notes: ^aPercentage of commercial, Medicare, and Medicaid plans that cover the product as preferred (IQVIA SMART). ^bCost variations in response to innovative treatments entry or other relevant events in the disease area (IQVIA SMART, 2015–2021). ^cRepresents the routes of administration that account for 60–70% of the share. ^dQualitative rating summarizing the improvement on key endpoints; Data from package insert by product. ^eIQVIA MIDAS, last reported price; Price RX; Monthly cost calculated based on prescribing information, each product label. ^fBased on product label. Short-term <1 year; Mid-term 1–3 years; Long-term >3 years. ^gBased on GoodRx coverage by insurance; X = Employer’s opt-in required at current state.

Abbreviation: WAC, wholesale acquisition cost.