Psoriatic Arthritis – Access and Reimbursement – Access & Reimbursement – Psoriatic Arthritis (US)

The PsA therapy market is undergoing significant transformation with the emergence of new treatment options, intensifying competition for favorable payer coverage. TNF-α inhibitors, such as AbbVie’s Humira, Amgen’s Enbrel, and Johnson & Johnson Innovative Medicine’s Simponi, dominate as first-line biologics, driven by payer policies. However, non-TNF biologics, including IL-17 inhibitors like Novartis’s Cosentyx and Lilly’s Taltz, and IL-23 inhibitors like Johnson & Johnson Innovative Medicine’s Tremfya and AbbVie’s Skyrizi, are expanding their presence despite stricter reimbursement hurdles. UCB’s Bimzelx, an IL-17A/F dual inhibitor, offers a differentiated mechanism of action, though its uptake may be challenged by payer stringency and the need to demonstrate clear value. Meanwhile, the growing availability of adalimumab biosimilars and the emergence of oral agents are reshaping the competitive dynamics, with payers increasingly favoring cost-effective options. This report provides insights into how evolving payer policies influence prescribing patterns and explores strategies for marketers to navigate the challenging reimbursement landscape in the PsA market.

QUESTIONS ANSWERED

• Which are the patient-share leaders among PsA biologics, and which PsA agents do physicians and payers believe perform best on specific clinical and market access factors?
• What are the biggest reimbursement hurdles that PsA drugs face?
• What are physicians’ perceptions of the new and emerging agents like Bimzelx and Sotyktu, respectively, and how do payers anticipate covering these agents?
• What pharmacoeconomic models and data do payers value given the likely cost and efficacy of novel psoriasis agents?

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.

Primary research: Survey of 50 U.S. rheumatologists, 50 U.S. dermatologists, and 30 U.S. managed care organization (MCO) pharmacy and medical directors (PDs/MDs).

Fingertip Formulary: Formulary coverage by commercial plans covering more than 164.3 million lives nationally.

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

Key drugs: Remicade, Humira, biosimilar adalimumab, biosimilar infliximab, Xeljanz, Rinvoq, Skyrizi, Cosentyx, Taltz, Bimzelx, Tremfya, Skyrizi, and Sotyktu.