Rheumatoid Arthritis | Access and Reimbursement | US | 2018


The crowded U.S. rheumatoid arthritis (RA) market boasts nine different biologics representing five distinct drug classes, including the blockbuster tumor necrosis factor-alpha (TNF-α ) inhibitors, Amgen’s Enbrel, AbbVie’s Humira, and Janssen’s Remicade, as well as Pfizer’s oral Jak inhibitor, Xeljanz. Fueling more competition and pricing pressure, two infliximab biosimilars are now marketed in the United States (Pfizer/Celltrion’s Inflectra and Merck’s Renflexis). With the impending entry of additional Jak inhibitors, in particular Olumiant, and biosimilars of several other TNF and non-TNF biologics, marketers are faced with fierce competition and increasing challenges to gain favorable formulary position and market uptake.

Questions Answered:

  • What are physicians’ and payers’ initial reactions to Inflectra and Renflexis, and how will their market entry impact physician prescribing and reimbursement of Remicade?
  • What types of pharmacoeconomic outcomes data do payers find most compelling for a novel RA therapy?
  • What are current physician perceptions of emerging Jak inhibitors Olumiant (Eli Lily/Incyte), upadacitinib (AbbVie), and filgotinib (Galapagos/Gilead), compared with Xeljanz?
  • How will rheumatologists’ prescribing of established biologics by line of therapy shift with the entry of multiple novel or less costly agents, including additional Jak inhibitors, and biosimilar versions of Remicade, Rituxan, and Orencia?
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