Despite Formulary Coverage of Several Biologic Agents for Rheumatoid Arthritis in Argentina and Mexico, Low Biologic Treatment Rates Characterize These Markets

Budgets are Limiting Wider Prescribing of Biologics; However, Access Will Improve with the Launch of New Drugs and Biosimilars, According to a New Report from Decision Resources

Oct 28, 2013, 09:00 ET from Decision Resources

BURLINGTON, Mass., Oct. 28, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that the rheumatoid arthritis (RA) armamentarium in Argentina and Mexico includes a wide range of premium-priced biologics. However, surveyed rheumatologists estimate that a significant percentage of their biologics-eligible RA patients—up to 53 percent in Mexico—fail to receive a biologic due to cost, budgetary, or reimbursement reasons. According to respondents, biologics are prescribed to approximately one-third of their drug-treated patients in Argentina and one-quarter of their drug-treated patients in Mexico. Patient shares of RA biologics decrease considerably among uninsured public patients (without social security coverage).

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The Emerging Markets Physician & Payer Forum report entitled Rheumatoid Arthritis in Argentina and Mexico: Physician and Payer Perspectives on Prescribing Trends, Patient Access, and Reimbursement Challenges for Current and Emerging Therapies finds that the uptake of costly therapies for RA in Argentina and Mexico highly depends on the ability of these agents to achieve inclusion in key national and/or institutional drug formularies. Biologic prices preclude out-of-pocket purchase for most of the population, and a government-sponsored route is the most commonly used by patients. 

"Payers in these markets are expecting that, upon patent loss for several biologics, the commercialization of imported and locally produced biosimilars will increase the competitiveness of the market," said Decision Resources Director Andreia Ribeiro, Ph.D. "Biosimilars will find a fertile terrain in Mexico, where two copies of etanercept (Amgen/Pfizer's Enbrel) approved for RA, and one of rituximab (Roche's MabThera) approved for non-Hodgkin lymphoma, are already being prescribed by surveyed physicians for RA. In Argentina, payers foresee that the launch of biosimilars will reduce costs, expand formulary inclusion and improve patient access. Brand manufacturers will need to discount heavily to win competitive tenders."

The findings also reveal that Pfizer's Xeljanz and Elli Lilly's baricitinib—both oral Jak-inhibitors in development in these markets—are deemed by payers to be well-positioned for formulary inclusion. Surveyed rheumatologists indicate that they expect to use Xeljanz and baricitinib primarily after failure of treatment with one TNF-alpha inhibitor or in patients who are naive to biologic treatment, but the majority of respondents expect reduced prices for these agents relative to AbbVie's Humira. Interviewed payers believe that the oral formulation and the efficacy, considered comparable or slightly superior to current brands, are powerful advantages carried by these agents. However, as health technology assessment is rapidly becoming the most powerful driver of market access in Argentina and Mexico, new RA therapies not only need to establish a strong clinical profile but also demonstrate improved cost-benefit over the available therapies in order to optimize uptake.

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