Reversing access decline: How mature brands can still make gains

See how one pharmaceutical brand observed a 22-percentage-point change[0]IQVIA CoverMyMeds Program Impact Analysis 09/23, Claim Approval Rate 5-year combined average in claim approval rates in a case study after competitors crowded its therapeutic class.

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Line chart showing claim approval rates for a mature GLP-1 brand declining from 46% to 19% over five years as market competition increases from 3+ to 5+ competitors.

The slow squeeze on a mature brand

As a therapeutic class matures, the ground shifts under an established brand. New competitors enter. Health plans tighten formulary strategies and lean harder on prior authorization. File teams scale back. Provider and patient acquisition slows.

In a case study of one mature GLP-1 brand, claim approval rates declined from 46% to 19% over five years[0]IQVIA CoverMyMeds Program Impact Analysis 09/23, Claim Approval Rate as competition crowded the class. The brand wasn’t losing efficacy – it was losing access.

Bar chart showing higher claim approval rates for a sponsored program versus control, with a 15 to 27 percentage point lift over five years, contributing to an average 22-point increase.

Lift in claim approval rates

By streamlining the prior auth process, the brand improved submission flow and follow-through across the provider workflow. Over five years, this contributed to a 22-percentage point average lift in claim approval rates,[0]IQVIA CoverMyMeds Program Impact Analysis 09/23, Claim Approval Rate 5-year combined average with increased plan submissions identified as a key driver.

What's inside the case study

  • Why mature brands lose access

    The market dynamics behind the slip from 46% to 19%[0]IQVIA CoverMyMeds Program Impact Analysis 09/23, Claim Approval Rate claim approvals.

  • The 22-point lift

    A five-year, side-by-side comparison of sponsored vs. control claim approval rates.[0]IQVIA CoverMyMeds Program Impact Analysis 09/23, Claim Approval Rate 5-year combined average

  • Designing a strategy that scales

    The operational elements that make a prior auth strategy work at scale.

  • Results across the full provider base

    Why the lift held up across low-, mid-, and high-volume prescribing offices.

CASE STUDY

From Decline to Growth: How One Brand Expanded Access in Late Lifecycle

Learn how one brand identified breakdowns and implemented a strategy to improve approvals and sustain access in a crowded class.

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