There are starting to get formulary traction nationally, but there are still some regions that are slow adopters who are behind. Much of that is fear of the volume that will come when they open up formulary access.

Same thing happened when the hepatitis C market exploded. States and plans dragged their feet for years citing that they needed guidelines to tell them what to do but time goes by and eventually they have to acquiesce.

The work they are doing now softens the road for all of the other MASH players that follow. Everyone wants to be first in a given market, but it comes with a price.