Aimmune Therapeutics, Inc. (NASDAQ:AIMT) Q2 2020 Earnings Conference Call - Final Transcript
Jul 30, 2020 • 04:30 pm ET
our next question comes from the line of Chris Raymond with Piper Sandler. Your line is open. Please go ahead.
Thanks. Maybe a question for Andrew, if possible. And sorry, Andrew, if this has been sort of explained already. But I just wanted to dig into the payer metrics you gave. I think I heard you say 39 plans have policies in place, and I think you said that, that represents 42% of your target population. Can you just clarify, does that mean that all 39 plans have favorable formulary decisions? Or is there some sort of categorization in that group that -- like different buckets that they fit into? And then I have a follow-up.
Yes. It's a good question, Chris. So yes, so there are 39 plans with policies which spell out the prior authorization criteria that must be fulfilled for a patient to be able to be treated with PALFORZIA. So from a plan perspective, if you're a patient, there are two ways in which you can have your PALFORZIA treatment covered. One is by obviously having it on formulary, or the other is via having on medical exception if it's not on formulary. In either case, the prior authorization is key, and that is the criteria that will be used, whether it's on formulary or whether it's on by medical exception, in order for the patient to be given a treatment. And this is standard for specialty products to have that -- those sort of criteria.
So the focus of our payer team right now is making sure that prior authorization criteria is in line with the label and doesn't create undue burden or barriers for patients to quickly get on product. I'm very pleased to say that we've -- we're around 80% of the prior authorization criteria that had been written for those 39 policies. It's very acceptable in our eyes in terms of being able to get patients on to product.
Whether or not a patient is -- whether or not a plan has a formal formulary position or whether it's via medical exception, the co-pay level will be the same. It's either going to be Tier 3 or Tier 4, depending on the design of the plan. And therefore, the co-pay level will be the same. And the patient, if it's a commercial patient, can work with us to buy down that co-pay level to as little as $20 a month. So our focus right now is getting those policies published and making sure that when they're published, we're working with the payers so that the criteria are consistent with the label and the appropriate patient population for the drug. And just a slight correction on what you said. It's 39 policies covering 102 million lives, and that represents 46% of the 220 million lives that we're targeting.
Okay. Great. Thanks for that clarification. And then obviously, there's been a lot of talk about regional differences in terms of opening back up from