Theratechnologies Inc T.TH

How does Trogarzo get onto formulary lists?

[PoorOpinion]

I've been trying to work out the answer to this. I'm coming from a position where I know nothing about this but I think I made some progress. Anybody with more insight would be appreciated.

From what I can see a Pharmacy and Therapeutics (P&T) Committee seems to be the standard designation for the group of independant medics/pharmacists that meet to discuss changes to drug formularies. All insurance/state health departments/medicare/medicaid organizations seem to have these P&T committees that decide on changes to formularies. Most seem to meet on a quarterly basis, although I came across one that meets bimonthly and one that seemed to promise to review all new FDA approved drugs within 6 months of approval date. I'm assuming it will depend on where each committee is in its cycle on how quickly Trogarzo will get reviewed, but it does look like it shouldnt take more than a few months for each of these committees to look at Trogarzo.

There are a lot of formularies available online for each of the insurance/government organizations, they tend to be dated indicating they are regularly updated. Most of the formularies do not yet have Trogarzo listed, which is maybe unsurprising but it might be useful to keep an eye on these to see how quickly it develops. I actually found one formulary that already has Trogarzo listed, maybe unsurprising it's in San Francisco :)

https://client.formularynavigator.com/Search.aspx?siteCode=9743708353&targetScreen=3&drugBrandListBaseTC=anti-infective%2Bagents%257chiv%2Bentry%2Band%2Bfusion%2Binhibitors

I havent searched a large number of these formularies so there are likely more out there leading the charge. As this formulary indicates payment for HIV drugs does not come through the health plan itself but via Medicaid. My understanding, I could be wrong, is that even with private health insurance there is often Medicaid is involved in paying for at least part of the anti-HIV drugs (through ADAP is my understanding)

I intend to keep an eye on these over the coming months to see how this develops. If I've got any of this wrong then please correct me.