Comments from Decision Resources Group Analyst Ronnie Yoo, Ph.D.:
- "Obtaining preferred brand coverage for RA therapies on commercial and Medicare Advantage plans 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."
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