 Physician & Payer Forum --
August 2008
 In This Issue...
The market for biological therapies to treat rheumatoid
arthritis (RA) is rapidly evolving into a crowded, competitive, and mature
market. At the beginning of 2008, six biological agents were approved to treat
RA and several more are expected to launch over the next two years.
Rheumatologists will be faced with a new array of choices to treat their
patients with moderate-to-severe disease, but will likely encounter continued and
new obstacles to expanding their use of these expensive agents.
Decision Resources’ Physician and Payer Forum report,
"Biologics in Rheumatoid Arthritis: Physician and Payer Perspective on Recently Launched and Emerging
Biologics in Rheumatoid Arthritis" explores what impact Orencia and
Rituxan have had on this market since their launch in 2006, and how four novel
agents will compete with existing brands in the Medicare and private insurance sectors.
We surveyed 103 U.S. rheumatologists and 21 MCO
pharmacy directors and compared their responses to assess similarities and
differences. This survey enabled Decision Resources to achieve the following:
- Understand how rheumatologists’ prescribing habits have
changed since the launch of Orencia and Rituxan, and what factors have
driven these changes. How do prescribing patterns differ between the
Medicare and private insurance sectors?
- Discern how two TNF-alpha inhibitors,
Centocor/Schering-Plough/Tanabe/Janssen’s golimumab and UCB’s Cimzia
(certolizumab pegol) will compete against established TNF-alpha inhibitors,
in the Medicare and private insurance sectors.
- Discover which agents are most threatened by Roche/Chugai’s
interleukin-6 inhibitor Actemra. Why do rheumatologists say they will, or
won’t prescribe this agent?
- Analyze the current formulary tier assignments of
biologics for RA based on plan type (including Medicare
PDP, Medicare Advantage, and private plans), and review the cost controls
(including reauthorization and use of specialty pharmacies) imposed by
agent and plan type. Understand whether managed care organizations will establish
policies that favor specific biologic agents or classes of agents.
- Discover what drug attributes, and patient/clinical
features currently guide pharmacy directors’ decisions to reimburse
treatment with biologic agents.
- Understand the factors influencing formulary inclusion,
and analyze the future tier assignments of emerging brands.
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