Psoriasis | Access & Reimbursement | US | 2024

The arrival of newer and more effective treatments in the U.S. psoriasis market is changing the treatment landscape and fueling competition for favorable coverage from MCOs. After years of dominance of well-entrenched biologics, such as AbbVie’s Humira, Janssen’s Stelara, and Novartis’s Cosentyx, newer agents like Amgen’s oral PDE-4 inhibitor Otezla, Eli Lilly’s IL-17 inhibitor Taltz, and Janssen’s IL-23 inhibitor Tremfya have successfully found their place in the treatment algorithm. AbbVie’s Skyrizi, the latest IL-23 inhibitor, outperforms earlier biologics on the market and is gaining on the established market leaders. The recent entries of Sotyktu (BMS’s oral TYK2 inhibitor) and Bimzelx (UCB’s IL-17 A/F dual inhibitor), along with the increasing penetration of adalimumab biosimilars, are further intensifying the competition. This report provides valuable insights into how payer coverage policies influence dermatologists’ prescribing decisions, helping marketers navigate this challenging market access environment.

QUESTIONS ANSWERED

• Among commercially insured psoriasis patients, what percentage receive newer targeted agents, and how do MCO restrictions impact physicians’ prescribing of biologics / oral targeted agents?
• How do payers cover biosimilar versions of adalimumab (e.g., Amgen’s Amjevita, Boehringer Ingelheim’s Cyltezo), and how do physicians prescribe these biosimilars?
• How do MCOs cover branded biologics / oral targeted agents in their largest fully insured commercial plans, and what economic factors most influence favorable coverage?

PRODUCT DESCRIPTION

U.S. Access & Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of U.S. payer policy on physician prescribing behavior in the market access environment. Each report includes up-to-date analyses of drug coverage and restriction policies as well as payer and prescriber perspectives on key marketed drugs and their receptivity to emerging therapies.

SOLUTION ENHANCEMENT

Access & Reimbursement includes key analyses from Clarivate Real-World Data Product—comprehensive and timely data that provide clarity around the healthcare experiences and activities of hundreds of millions of patients, HCPs, and payers. Analyses include payer mix, percentage of claim rejections for key therapies, and reasons for claim rejection.

Key drugs: Humira, Amjevita, Enbrel, Remicade, Inflectra, Renflexis, Avsola, Cimzia, Stelara, Otezla, Cosentyx, Taltz, Siliq, Tremfya, Ilumya, Skyrizi, Bimzelx, Sotyktu

Key companies: AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly, Janssen, Merck, Pfizer, Novartis, UCB​