Cost-Constrained Payers Across the EU5 Welcome the Launch of Biosimilars in the RA Market and Anticipate Encouraging or Imposing the Prescription of These Agents to Control the Spending of High-Cost Biologics

Sep 03, 2015, 08:30 ET from Decision Resources Group

BURLINGTON, Mass., Sept. 3, 2015 /PRNewswire/ -- Decision Resources Group finds that surveyed rheumatologists across the EU5 (France, Germany, Italy, Spain, and the United Kingdom) estimate that within the first year of biosimilar availability, more than 30% of RA patients newly starting on a drug will receive the biosimilar version. Interviewed payers in most EU5 countries indicate that measures will likely be implemented to recommend or require the use of biosimilars, especially in patients newly receiving a molecule. Switching of branded agents to its biosimilar counterparts is not anticipated to be mandated until rheumatologists and payers gain more experience with biosimilars and long-term efficacy and safety data become available. Interviewed payers expect emerging RA agents to be faced with stiff competition due to the recent launch of biosimilar infliximab and the expected arrival of biosimilars of etanercept, rituximab, and adalimumab in the next few years, making it increasingly difficult for them to obtain high prices. In addition, the RA market is intensely competitive and filled with numerous efficacious drugs, posing a big challenge for emerging therapy uptake.

Other key findings from the EU5 Physician & Payer Forum report entitled "EU5 Market Access Opportunities and Challenges in Rheumatoid Arthritis":

  • Interviewed payers emphasize that emerging therapies must demonstrate superiority over the standard of care TNF-alpha inhibitors in head-to-head trials for optimal pricing and reimbursement negotiations. Without this data, emerging therapies will likely be priced at the same level, or lower, than the marketed agents including biosimilars.
  • Given the availability of the lower-cost biosimilars, interviewed payers report that negotiating discounts, rebate contracts, and risk-sharing schemes will be key market access levers for the uptake of new agents in the crowded RA market.
  • The majority of surveyed rheumatologists indicate that they would urge local or regional payers to reimburse an oral Jak kinase inhibitor, a novel drug class in RA. However, they also anticipate that Xeljanz, an emerging Jak inhibitor, will only achieve moderate uptake by year-end 2018 and most likely be prescribed in the later lines of therapy.

Comments from Decision Resources Group Analyst Ronnie Yoo, Ph.D.:

  • "Given the increasingly constrained reimbursement environment across the EU5 and in the absence of superiority data to an active comparator, it may be difficult for Xeljanz to gain access to a broad patient population if prices are on par with Humira. Payers believe Xeljanz will need to be priced at a discount to marketed biologics for use in the earlier lines of treatment."
  • "Payers note the challenges emerging agents face with the large number of effective RA agents with established safety profiles. Biosimilar availability will further heighten the bar for cost-effectiveness, which is a key to EU5 reimbursement and market access."

Additional Resources:

  • Decision Resources Group will present a webinar based on this report entitled Market Access Dynamics for Immunobiologics in the EU5; Impact of Emerging Oral and Novel Biologics and Biosimilars on Treatment for Rheumatoid Arthritis (RA) and Spondyloarthritis (SpA).

For more information on purchasing this report, please email questions@dresourcesgroup.com.

About Decision Resources Group

Decision Resources Group offers best-in-class, high-value data, analytics and insights products and services to the healthcare industry, delivered by more than 900 employees across 14 global locations. DRG provides the pharmaceutical, biotech, medical device, financial services and payer industries with the tools, insights and advice they need to compete and thrive in an increasingly complex and value-based marketplace. DecisionResourcesGroup.com.

Media contact: 
SHIFT Communications 
Theresa Masnik 
617.779.1871 
dresourcesgroup@shiftcomm.com

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SOURCE Decision Resources Group



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