Benlysta Is Likely To Be Covered Equally Under Pharmacy or Medical Benefit in Surveyed MCOs’ Largest Commercial Plans, According to a New Report from Decision Resources
BURLINGTON, Mass.--(BUSINESS WIRE)-- Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that the uptake of Human Genome Sciences/GlaxoSmithKline’s emerging B-cell inhibitor Benlysta over the next two years for the treatment of systemic lupus erythematosus (SLE) will not lead to a decline in the patient share of immunosuppressant/cytotoxic agents or for Roche/Biogen Idec’s Rituxan (Roche’s MabThera, Chugai/Zenyaku Kogyo’s Rituxan), according to surveyed rheumatologists. However, surveyed rheumatologists anticipate a significant reduction in their use of corticosteroids through 2013, most likely due in part to their anticipated adoption of Benlysta.
The new U.S. Physician & Payer Forum report entitled Benlysta in Systemic Lupus Erythematosus: How Will US Physicians and Payers React to the Approval of the First Biologic in a Largely Genericized Market? finds that, overall, surveyed rheumatologists foresee more widespread use of Benlysta compared with Rituxan by 2013. More than one quarter of surveyed rheumatologists believe they will use Benlysta as an add-on therapy in moderate to severe SLE, which is in line with the finding that physicians do not anticipate any one drug, aside from corticosteroids, will lose substantial patient share to Benlysta in SLE over the next two years.
“As with Rituxan, one of the key patient groups most likely to be targeted for Benlysta treatment are those with severe disease and hematological involvement,” said Decision Resources Analyst Iva Holder, Ph.D. “Additionally, more physicians will use Benlysta to treat patients with severe disease compared to moderate SLE patients, which is consistent with the expectation that Benlysta will see most of its use in patients who have exhausted other treatment options.”
The report also finds that Benlysta is likely to be covered equally under pharmacy or medical benefit in surveyed managed care organizations’ (MCOs) largest commercial plans, regardless of its surveyed price per year. Only 5% of surveyed MCO pharmacy directors (PDs) indicate that they will exclude Benlysta from coverage in their largest commercial plan. Expectations of tier status placements for Benlysta are similar across all surveyed prices, but its anticipated pharmacy coverage will likely relegate Benlysta to tier three or higher with most MCOs, as is the case for Rituxan and Orencia.
Benlysta in Systemic Lupus Erythematosus: How Will US Physicians and Payers React to the Approval of the First Biologic in a Largely Genericized Market? is based on a U.S. survey of 100 rheumatologists and 20 MCO pharmacy directors.
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Decision Resources (www.decisionresources.com) is a world leader in market research publications, advisory services and consulting designed to help clients shape strategy, allocate resources and master their chosen markets. Decision Resources is a Decision Resources, Inc. company.
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