When Prescribing New Drugs for Crohn's Disease or Ulcerative Colitis, Surveyed EU5 Gastroenterologists Will Prioritize Remission Rates Over Cost and Reimbursement Hurdles However, Novel Agents Will Face Reimbursement and Uptake Challenges if Robust Superiority over Anti-TNFs is Lacking, According to a New Report from Decision Resources
BURLINGTON, Mass., Dec. 16, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that, when considering the most important attributes for prescribing emerging therapies for Crohn's disease (CD) and ulcerative colitis (UC), instead of using leading anti-TNF agents (Merck's Remicade and AbbVie's Humira), 44 to 70 percent of surveyed gastroenterologists cite higher rates of induction and maintenance of remission as the primary driver. In addition, 12 to 34 percent of surveyed gastroenterologists identify superior efficacy over anti-TNFs in head-to-head trials as another driver, while only up to 10 percent of physicians list the nonclinical factors, lower cost burden and fewer reimbursement restrictions.
Lack of initial efficacy and waning efficacy over time are also the primary reasons currently driving discontinuation of the anti-TNF-alpha agents, according to survey respondents. While the emerging biologics vedolizumab (Takeda) for CD and UC and Stelara (Janssen) for CD show at least comparable efficacy at maintenance of remission when indirectly compared to Remicade, in the absence of head-to-head comparative data that show superiority over this agent or other anti-TNFs, vedolizumab and Stelarawill face challenges in gaining preferential uptake.
The European Physician & Payer Forum report entitled Crohn's Disease and Ulcerative Colitis in the EU5: How Will Pricing and Reimbursement Decisions for Novel Biologics and Oral Immunomodulators Impact Prescribing? also emphasizes the importance of direct comparative data for favorable pricing and reimbursement of emerging biologics. As more rigorous health technology assessments that focus on added benefit are introduced across the EU5, proven superiority over appropriate comparators is increasingly required for optimal pricing and reimbursement. For example, based on indirect comparison with Remicade, interviewed payers believe that the clinical profile of vedolizumab in CD or UC is not strong enough to justify reimbursement before anti-TNFs if priced at a 25 percent or greater premium.
"While EU5 gastroenterologists expect vedolizumab to encroach on their use of anti-TNFs by the end of 2017, in the absence of a head-to-head trial showing evidence of superior efficacy that may justify use before anti-TNFs and with a potentially higher price, anti-TNFs will continue to dominate patient share," said Decision Resources Analyst Kathrina Quinn, Ph.D. "These data also reflect the expected entry of the more favorably priced biosimilar infliximab, which will bolster drug class share. At least 74 percent of surveyed gastroenterologists expect to prescribe biosimilar versions of Remicade within a year of availability for either CD or UC, but many are willing to do so under certain conditions only, such as if an acceptable safety and/or immunogenicity profile is shown."
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SOURCE Decision Resources