Systemic Lupus Erythematosus – Access & Reimbursement – Access & Reimbursement – Systemic Lupus Erythematosus (US)

The U.S. systemic lupus erythematosus (SLE) therapy market is largely genericized and off-label. With the exception of GSK’s Benlysta, the firstagents approved for the indication in almost 60 years are AstraZeneca’sSaphnelo, Aurinia’s Lupkynis, and Roche’s Gazyva. Because all approved targeted therapies are expensive, payers usually restrict access to them. Several therapies are in late-phase development for SLE. This report examines the prescribing and reimbursement environment for key current and emerging SLE agents in the United States, according to surveyed rheumatologists and MCO PDs / MDs. It explores how physicians and payers perceive current and emerging SLE therapies and the reimbursement dynamics that will promote or restrict market access to the agents.

QUESTIONS ANSWERED

• What is the extent of MCO coverage of Benlysta, Saphnelo, Lupkynis,Gazyva, and off-label Rituxan, and how do the coverage policies affect rheumatologists’ prescribing of these drugs? Where do the rituximab biosimilars fit in the SLE treatment algorithm?
• How has the approval of Gazyva for lupus nephritis (LN) affected its coverage on commercial plans? Where in the treatment algorithm have physicians begun using Gazyva?
• How do physicians anticipate using ianalumab, dapirolizumab pegol, litifilimab, upadacitinib, and deucravacitinib, all of which are indevelopment for moderate to severe nonrenal SLE, and how do payers expect to cover these therapies on commercial plans?

PRODUCT DESCRIPTION

Leveraging Clarivate’s proprietary data sources and surveys with physicians and payers, Access & Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of payer policy on physician prescribing behavior in the United States. Through detailed analyses of drug coverage, restriction policies, and contracting, as well as payer and prescriber perspectives on key marketed drugs and their receptivity to emerging therapies, this report enables you to:

• Identify and learn how to overcome roadblocks to market access to best position your brand.
• Identify key stakeholders and reimbursement drivers and assess the impact that reimbursement decisions have on treatment selection.
• Evaluate competitor strategies for securing favorable market access terms.

Geography: United States.

Primary research: Survey of 100 U.S. rheumatologists and 30 U.S. managed care organization (MCO) pharmacy and medical directors (PDs/MDs). Interviews with 2 U.S. MCO PDs/MDs.

Fingertip Formulary: Formulary coverage by commercial plans covering more than 163 million lives nationally.

Real-world data: U.S. pharmacy and medical claims data

Key drugs covered: Benlysta, Saphnelo, Lupkynis, Gazyva, Rituxan, deucravacitinib, ianalumab, litifilimab, upadacitinib.