Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that, in the United States, approximately 80 percent of current prescribers of Janssen Biotech/Merck/Mitsubishi Tanabe’s Remicade and/or Biogen Idec/Roche/Chugai/Zenyaku Kogyo’s Rituxan indicate they would prescribe biosimilar versions of these agents within a year of their approval. However, about half of these physicians expect to prescribe biosimilar versions of Remicade or Rituxan only if a patient requests it and/or insurance plans demand it.
Additionally, most surveyed physicians do not plan to prescribe the branded agents to patients who fail the biosimilar versions. Approximately half of surveyed physicians who anticipate prescribing biosimilar Remicade or Rituxan will wait one to six months, while over one-third will wait longer before doing so. Surveyed rheumatologists will delay prescription of biosimilars likely because of their familiarity with the branded agents and their hesitation to prescribe biosimilars due to concerns about the complexity of manufacturing antibodies and the safety of these therapies.
The new U.S. Physician & Payer Forum report entitled also finds that, in the first three years following its launch, surveyed rheumatologists expect that Pfizer/Takeda's Xeljanz will predominantly be used in biologic-experienced patients.
“If reimbursed on a preferred tier - tier 1 or 2 – Xeljanz will be used in slightly more patients after failure with one or two biologics, whereas if it is on a non-preferred tier nearly similar percentages of patients will be from these two treatment lines as from more-refractory lines of therapy,” said Decision Resources Analyst Bingnan Kang, Ph.D. “Approximately one-sixth of surveyed rheumatologists do not expect to prescribe Xeljanz by year-end 2015, regardless of its tier positioning.”
Xeljanz may face significant reimbursement hurdles during the first year of its market availability that could stifle its patient access potential. Only half of surveyed payers expect to possibly cover the agent in their largest commercial plans, and only a quarter expect to cover it in their largest Medicare PDPs if the price is appropriate or irrespective of price. The anticipated high cost of the agent is the most-frequently cited reason for plan exclusion.
The report also finds that, among insurers that currently cover Remicade or Rituxan, half of commercial plans will not likely cover biosimilar versions of either agent by 2015. In contrast, only about one-third of surveyed Medicare Part D Plans (PDPs) that cover each drug expect to exclude biosimilars. This indicates that biosimilars may be covered more extensively, on a percentage basis, by Medicare PDPs that cover brands susceptible to biosimilar competitors.
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