Evolution of the Rheumatoid Arthritis Treatment Paradigm | Physician & Payer Forum | EU5 | 2015

The entrenched positioning of biologics (in particular, tumor necrosis factor-alpha [TNF-alpha] inhibitors) to treat moderate-to-severe rheumatoid arthritis (RA) has generated a multi-billion-dollar market. The non-TNF-alpha inhibitor agents Orencia (Bristol-Myers Squibb’s abatacept), Rituxan (Roche/Biogen Idec/Chugai/Zenyaku Kogyo’s rituximab), Actemra (Roche/Chugai’s tocilizumab), and Xeljanz (Pfizer’s tofacitinib) largely compete for TNF-alpha inhibitor-refractory patients. Additional Jak inhibitors (Eli Lilly/Incyte’s baricitinib and Galapagos’s filgotinib) and IL-6 inhibitors (Sanofi/Regeneron’s IL-6 inhibitor sarilumab and Janssen/GlaxoSmithKline’s IL-6 inhibitor sirukumab) are anticipated to launch over the next few years and to further intensify competition in the crowded RA market. In addition, biosimilar versions of Janssen’s Remicade (infliximab), AbbVie/Eisai’s Humira (adalimumab), and Rituxan are expected to launch in the United States starting in 2016, providing cost-effective alternatives to the high-cost biologics. The U.S. Physician & Payer Forum report entitled Evolution of the Rheumatoid Arthritis Treatment Paradigm: U.S. Physician and Payer Perceptions as More Convenient Options Emerge examines the prescribing and reimbursement environment for current and emerging RA agents according to surveyed rheumatologists and managed care organization (MCO) pharmacy directors and medical directors. This report explores stakeholder perspectives that affect prescribing and reimbursement of key RA agents and dynamics that will promote or restrict market access and uptake of emerging RA therapies.