Other key findings from the Access & Reimbursement content entitled Rheumatoid Arthritis Access & Reimbursement Overview and Detailed, Expanded Analysis in the US:
- According to surveyed payers, the net cost of a drug (after rebates and discounts) is the key driver in formulary decisions for RA therapies, followed by efficacy in reducing signs and symptoms of disease.
- Supported by physician familiarity, long-term safety data, and favorable formulary coverage, the leading TNF-alpha inhibitors, Enbrel and Humira, are most frequently prescribed as first and second-line biologics for commercially-insured RA patients refractory to conventional disease modifying antirheumatic drugs (DMARDs), according to surveyed rheumatologists.
- Despite its slow start, Xeljanz, the first oral JAK inhibitor approved for RA, has been gaining patient share in the earlier lines of therapy of surveyed rheumatologists, likely owing to growing physician experience and comfort with the agent. Increased market access and reimbursement may have also played a role in the uptake; surveyed payers report that Xeljanz's formulary coverage is similar to or more favorable than the other non-TNF-alpha inhibiting agents.
- The majority of surveyed payers anticipate that they will reimburse biosimilars of key RA agents (infliximab, adalimumab, rituximab, abatacept) in their commercial plans within a year of their respective launches.
- "Obtaining preferred brand coverage for RA therapies on commercial and
Medicare Advantageplans will only continue to become more difficult. As the costs of RA agents continue to climb, payers are likely to impose stricter prescribing controls or take further measures to require patients to obtain these high-cost agents from a specialty pharmacy."
- "It will be extremely challenging for emerging RA therapies such as baricitinib or sarilumab to achieve premium pricing without sacrificing formulary coverage or favorable tiering, especially with the impending entry of cost-effective biosimilars of the leading TNF-alpha inhibitors."
For more information on purchasing this report, please email [email protected]
To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/surveyed-mco-pharmacy-and-medical-directors-report-that-the-market-leading-tnf-alpha-inhibitors-enbrel-and-humira-continue-to-enjoy-the-most-favorable-formulary-coverage-in-the-united-states-300329284.html