For Treatment of Rheumatoid Arthritis, About One-Half of Surveyed U.S. Rheumatologists and Payers Indicate that Xeljanz Has Efficacy Comparable to TNF-alpha Inhibitors

Surveyed Physicians Report that Payer Hurdles are Not the Only Obstacles to Prescribing Xeljanz, According to a New Report from Decision Resources

Oct 17, 2013, 10:33 ET from Decision Resources

BURLINGTON, Mass., Oct. 17, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that approximately one-half of surveyed rheumatologists and payers report that they believe Pfizer's Xeljanz has a comparable effect on the signs and symptoms of rheumatoid arthritis (RA) in comparison to TNF-alpha inhibitors. In addition, approximately 40 percent of surveyed physicians and payers believe Xeljanz's safety profile is the same as the most widely used biologic agents. Interestingly, up to one-third of payers and physicians believe Xeljanz has a less favorable safety profile than TNF-alpha inhibitors. Physicians and payers also expressed mixed views on Xeljanz's effect on structural damage in comparison with the TNF-alpha inhibitors, which could constrain its uptake.

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The U.S. Physician and Payer Forum report entitled Rheumatoid Arthritis: U.S. Physician and Payer Perspectives on the Opportunity for Novel Oral Kinase Inhibitors, Newer Formulations of Established Biologics, Novel Biologics, and Biosimilars also finds that payer hurdles are not the only obstacles to prescribing Xeljanz. Xeljanz is commonly placed on tier 3 and is excluded in many of the large commercial plans surveyed in the study, which is a likely scenario for newer therapies until managed care organizations have more postmarketing data or better rebates from the drug firms. Traditional payer restrictions, such as prior authorization and step therapy requirements, are deemed to be barriers to prescribing the newest RA treatment. In addition, Xeljanz prescribers report that a limiting factor to their prescribing it is that their patients are adequately controlled with other agents. Xeljanz's perceived limited efficacy in inhibiting structural damage progression, along with not having the FDA approved indication for inhibiting structural damage progression, were also cited as barriers to prescribing the product.

"Physicians and payers are making it more difficult for new products to gain traction in an already crowded RA market by demanding better efficacy data and more concrete outcomes data, such as data showing the inhibition of structural damage progression,"  said Decision Resources Group Senior Director Greta Unger. "Currently, many plans require new RA products to demonstrate a statistically significant effect on inhibiting structural damage progression for reimbursement. Drug marketers of new agents can expect this to continue in the near future."

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